A review of Secondary Intention Healing in Dermatology and Dermatologic 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-epithelialisation and contraction. The surgeon and patient need to weigh up advantages and disadvantages of SIH versus 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 nose, eye, ear and temple (NEET) as these areas give rise to the best cosmetic outcomes. However, SIH has been shown to be a successful repair method in several convex locations including dorsa of hands, digital extremities, scalp, lips and eyelids. SIH can be supplemented by other surgical techniques including purse-string sutures and post-operative de-epithelialisation.