In wound closure, when is delayed primary closure preferred over primary closure?

• A. For contaminated wounds or high infection risk, allowing a drainage period before closure
• B. For clean wounds with minimal infection risk, primary closure is standard
• C. Immediate closure after injury
• D. Delayed closure is never indicated

Answer: (A)

In wound management, the timing of closure is guided by the level of contamination and infection risk. Delayed primary closure is used when a wound is contaminated or there’s a high risk of infection. The idea is to keep the wound open initially to allow drainage, perform cleaning and debridement, and manage infection. Once the wound bed is clean and draining risk has decreased—usually after a short period of drainage and observation—you close the wound. This approach reduces bacterial burden and the chance of infection or dehiscence compared with closing a contaminated wound immediately.

For clean wounds with minimal infection risk, you close primarily, not delay. Immediate closure after injury is primary closure, not delayed. And delayed closure is not never indicated; it’s specifically indicated in contaminated or high-risk wounds.