A review of secondary intention healing in dermatology and dermatological surgery: part 1

Secondary intention healing (SIH) describes wounds healing from the base upwards, without direct closure. This starts with granulation of the wound, followed by re-epithelialization and contraction. The surgeon and patient need to weigh up the advantages and disadvantages of SIH vs. other reconstruction methods. There are limited studies directly comparing SIH with skin grafts; however, SIH looks to be a robust alternative in specific settings. Well-established sites for SIH include concave areas such as the nose, eye, ear and temple, as these areas give rise to the best cosmetic outcomes. However, SIH has proven to be a successful repair method in several convex locations, including the dorsa of the hands, digital extremities, scalp, lips and eyelids. SIH can be supplemented by other surgical techniques, including purse-string sutures and postoperative de-epithelialization.