Wound healing differs according to how much tissue has been damaged. It occurs by first, second, and third intention. First intention healing occurs in wounds with minimal tissue loss, such as surgical incisions or sutured wounds. Edges are approximated (close to each other); thus they seal together rapidly.
Scaring and infection rate with first intention healing are low. Second intention healing occurs with tissue loss, such as in deep laceration, burns, and pressure ulcers. Because edges don’t approximate, openings fill with granulation tissue that is soft and pinkish. Later, epithelial cells grow over the granulation greater than
that for first intention healing.
Third intention healing occurs when there is a delay in the time between the injury and closure of the wound. For example, a wound
may be left open temporarily to allow for drainage or removal of infectious materials. This type of healing some times occurs after surgery, when the wound closes later. In the mean time, wound surfaces start to granulate. Scaring is common.
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