NPLEX II Minor Surgery Practice Test

The concept here is closing a contaminated wound after initial control of infection. When a wound is too dirty to sew up right away, the tissue is cleaned, debrided, and allowed to drain and settle for a short period. If the wound bed becomes clean enough and swelling and infection risk have decreased, the wound can be closed later. Doing this around 3–4 days after initial treatment is classic for a tertiary approach. This is the term for delayed closure after initial management to reduce infection risk. Some sources call the same scenario delayed primary closure, but in this context the three-to-four-day timing fits tertiary intention. It differs from immediate primary closure, which is done right away when contamination is minimal, and from secondary healing, which is left to heal by granulation without surgical closure.