If a wound was heavily contaminated and is now clean after several days, what type of wound closure is indicated?

• A. Remove after 48 hours and exchange for a new one.
• B. Leave in place until it falls off.
• C. Remove after 12 hours.
• D. Replace every 3 days.

Answer: (A)

In contaminated wounds, you don’t close right away. The plan is to keep the wound open or only loosely closed to allow ongoing drainage and reassessment, and then close once the area is clean and free of infection. This approach, often called delayed primary closure or staged closure, reduces the risk of trapping infection and promotes proper healing.

The choice described—removing the temporary closure after about 48 hours and exchanging it for a new one—fits this staged approach. It allows continued drainage and monitoring during the early healing window, with definitive closure planned once the wound remains clean. Other options don’t align with this strategy: leaving a closure in place until it falls off bypasses the necessary reassessment, closing too early in a contaminated wound increases infection risk, and changing or replacing closures at longer intervals (like every 3 days) doesn’t provide the timely monitoring and drainage control the staged plan requires.