The approach to wound closure (Table) is influenced by multiple factors, including time elapsed since initial injury, degree of contamination, amount of tissue damage, wound location, extent of tension or dead space, and the patient’s general and local health.1 

Also known as first-intention healing

Involves immediate apposition of wound edges

Delayed primary closure may be indicated when there is a mild degree of contamination that cannot be removed with cleansing or debridement or when the health of the skin along the wound edges is questionable (eg, bite wounds).1,2  Secondary closure is commonly preferred when severe infection is present or periwound skin is unhealthy and cannot be fully resected.  Delayed primary closure and secondary closure require initial open wound management until the periwound skin and wound bed are healthy. 


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