What kind of wound healing method is applied when tissue loss is excessive?

When tissue loss is excessive, secondary intention is the appropriate wound healing method. This approach is utilized when wounds cannot be sutured directly due to the significant loss of tissue, making it impossible to bring the edges together. In secondary intention, the wound heals from the bottom up and the sides in, which allows for granulation tissue to form. This granulation tissue eventually contracts and re-epithelizes over time, filling in the wound as it heals.

Secondary intention is particularly relevant in cases where there is a large defect that cannot be closed, such as in certain traumatic injuries, surgical wounds with significant skin loss, or chronic wounds that fail to heal quickly. By allowing the wound to heal naturally, it has the opportunity to form new tissue and recover.

In contrast, primary intention refers to the healing of clean wounds where edges can be brought together, while tertiary intention involves delaying closure due to the risk of infection or other complications. Delayed primary closure is a specific method that allows a wound to be observed and treated first before being closed surgically, which may not always apply when tissue loss is excessive.