Primary and Secondary Healing in Infected Wounds

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Abstract
• The beneficial effects of delayed closure of contaminated wounds are recognized, but not well defined. Rats with abdominal incisions were infected with Staphylococcus aureus or Escherichia coli and then subgrouped for primary or secondary healing. Noninfected rats served as controls. Between seven and 119 days later, the wounds were subjected to breaking-strength determination, hydroxyproline analysis, and light and scanning electron microscopy. In the controls, secondary closure gave stronger wounds than primary closure. In those infected with S aureus the wounds were stronger than in the primary-closure control group, regardless of the closure method. Of the E coli–infected wounds, those primarily closed were weaker than those secondarily closed. Secondary closure gave infected wounds fewer complications. Biochemical and microscopic examination did not explain these findings. (Arch Surg 1982;117:1189-1193)