In many medical texts, one encounters the word "intention", that makes many students confused! Intention!? Yes, but it primarily means "healing" in medical contexts:
The healing of an incised wound by the direct union of skin edges without granulations
– When wound edges are brought together (sutured/glued) so that they are adjacent to each other (re-approximated),
– Minimizes scarring,
– Most surgical wounds heal by primary intention healing,
– Wound closure is performed with sutures (stitches), staples, or adhesive tape or glue.
Examples: well-repaired lacerations and well reduced bone fractures.
The healing of an incised wound by granulations that bridge the gap between skin edges
– The wound is allowed to granulate,
– Surgeon may pack the wound with a gauze or use a drainage system,
– Granulation results in a broader scar,
– Healing process can be slow due to presence of drainage from infection,
– Wound care must be performed daily to encourage wound debris removal to allow for granulation tissue formation.
Examples: Tooth extraction sockets, poorly reduced fractures, burns, severe lacerations, pressure ulcers.
When a wound is intentionally kept open to allow edema or infection to resolve or to permit removal of exudate
– The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure,
– The wound is purposely left open.
Examples: healing of wounds by use of tissue graft.