A physical therapist treats a patient with a full-thickness wound that is intentionally left open to heal. This approach was necessary due to significant tissue loss and jagged wound edges that could not be approximated? What type of healing is best described by this description?

1. Primary intention 
2. Delayed primary intention 
3. Secondary intention 
4. Tertiary intention 

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist treats a patient with a full-thickness wound that is intentionally left open to heal. This approach was necessary due to significant tissue loss and jagged wound edges that could not be approximated? What type of healing is best described by this description?

1. Primary intention 
2. Delayed primary intention 
3. Secondary intention 
4. Tertiary intention 

Healing by Intention

Healing by intention refers to the method by which a wound heals. Wound characteristics such as etiology, depth, border integrity, and wound bed contamination are typically considered when determining which closure method is most appropriate.

Let’s explore each of the options:

Option 1 - Primary intention 

Healing by primary intention is most commonly associated with acute wounds which have minimal associated tissue loss (e.g., surgical wound, laceration, puncture wound). In these wounds, clean edges are reapproximated and closed with sutures, staples or adhesives to facilitate re-epithelialization. 

Option 2 - Delayed primary intention 

Healing by delayed primary intention is most commonly associated with acute wounds that have minimal associated tissue loss, but are at high risk for developing complications (e.g., infection, dehiscence). These wounds are temporarily left open until risk factors have been alleviated and then are closed by usual primary intention methods.

Option 3 - Secondary intention 

Healing by secondary intention is most commonly associated with wounds that have significant tissue loss, necrosis or borders that cannot be reapproximated (e.g., full-thickness wound, pressure ulcer). These wounds are left open and typically require specialized dressings and ongoing wound care to facilitate healing.

Option 4 - Tertiary intention 

Healing by tertiary intention is synonymous with healing by delayed primary intention. Risk factors such as wound bed contamination, infection, and significant local edema increase the risk of healing complications and must be addressed before the wound can be appropriately closed by usual primary intention methods. 

The correct answer is Option 3.

Let’s explore the all student data:

12% of students selected Option 1 – Primary intention
24% of students selected Option 2 - Delayed primary intention
52% of students selected Option 3 - Secondary intention – the correct response
12% of students selected Option 4 - Tertiary intention

System Classification
This question is an Other Systems question which represents approximately 21% of all exam items.

Content Outline Classification
This question is a Foundations for Evaluation, Differential Diagnosis, and Prognosis question which represents approximately 33% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out pages 512-513 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q&A podcast! See you next week!