For wounds with high infection risk or established infection (such as bites or punctures), which wound closure method is used?

• A. Primary Closure
• B. Secondary Intention
• C. Delayed Primary Closure
• D. Tertiary Closure

Answer: (B)

The main idea is that infection risk determines whether a wound should be closed or left open to heal. When a wound is highly contaminated or already infected (as with bites or punctures), closing it right away can trap bacteria and debris, leading to abscesses, persistent infection, or wound breakdown. To prevent that, the wound is allowed to heal by secondary intention: it is left open and cleaned, then allowed to granulate from the bottom up with gradual contraction and epithelialization. This approach reduces the chance of trapping infection and drainage issues.

Delaying closure (closing later after the wound is cleaned) is used in some contaminated wounds where infection risk is present but can be controlled; primary closure would still seal in infection, and healing by secondary intention is chosen when active infection is a concern.