What is a hallmark of secondary intention healing?

• A. Wound edges are tightly approximated and closed with sutures
• B. Wound is left to heal from the bottom up with granulation tissue and epithelialization
• C. Wound heals instantaneously
• D. Wound remains closed with no drainage

Answer: (B)

The hallmark of secondary intention healing is that the wound is left open and heals from the bottom up, with granulation tissue filling the wound bed and epithelial cells migrating from the edges to restore the surface. This process takes longer than primary closure and typically results in more scar, with granulation tissue forming first to fill the defect and then epithelialization on top of it. This open-healing approach is used for wounds with tissue loss or contamination, where edges cannot be easily brought together.

In this context, the description that the wound is left to heal from the bottom up with granulation tissue and epithelialization matches secondary intention. By contrast, tightly approximated edges with sutures describe primary intention, instantaneous healing is not realistic, and a wound remaining closed with no drainage does not reflect the open, tissue-loss healing pattern of secondary intention.