HEALING BY THIRD INTENTION Meaning and
Definition
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Healing by third intention, also known as delayed primary closure or tertiary intention, is a medical term used to describe the process of closing a wound after a deliberate delay. This technique is often employed when the wound is contaminated or infected, or when there is a significant loss of tissue.
Unlike healing by first intention (primary intention) or second intention (secondary intention), healing by third intention involves a staged approach to wound closure. In this process, the wound is initially left open and managed with measures such as cleaning, irrigating, and applying dressings to promote granulation tissue formation and infection control. After a specific period of time, which can vary depending on the severity and characteristics of the wound, the wound edges are brought together and sutured, allowing for primary closure.
The main advantage of healing by third intention is that it allows for thorough wound cleaning and management of infection, minimizing the risk of complications such as abscess formation or wound dehiscence. It also enables tissue edema and inflammation to subside, reducing the tension on the wound edges and optimizing wound healing.
This technique is commonly used in surgical procedures involving contaminated or infected wounds, complex injuries with extensive tissue loss, or wounds that cannot be primarily closed due to excessive tension or inadequate tissue perfusion. Healing by third intention may require longer healing times compared to first or second intention healing, but it often results in an optimal outcome with improved wound healing and reduced risk of complications.
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The filling of a wound cavity or ulcer by granulations, with subsequent cicatrization.
A practical medical dictionary. By Stedman, Thomas Lathrop. Published 1920.
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