Which injury can safely be closed primarily with sutures?

Which injury can safely be closed primarily with sutures?

• A. Puncture wound on the plantar foot with contamination
• B. Contaminated puncture wound on plantar surface
• C. Clean, uncomplicated facial laceration in a healthy patient
• D. Avulsion with tissue loss on the hand

Answer: (C)

The main idea is that primary closure with sutures works best for wounds that are clean, have little to no contamination, and are in tissue with good blood supply so edges can be approximated securely. A clean, uncomplicated facial laceration in a healthy patient fits this perfectly: the face heals well because of abundant blood flow, and precise edge alignment with sutures gives excellent cosmetic and functional results with a low risk of infection when the wound is properly irrigated and debrided. In contrast, a puncture wound on the plantar surface that is contaminated should not be closed primarily. The contamination and the location increase the risk of trapping debris and bacteria under the sutures, which can lead to infection or abscess; such wounds are typically irrigated, debrided, and either left open or closed after delayed primary closure once the infection risk has diminished. An avulsion with tissue loss on the hand also isn’t suited to primary closure because the tissue defect and potential dead space make simple suturing inadequate; these injuries usually require more complex reconstruction, grafts, or staged closure to restore function and appearance. So the option describing a clean, uncomplicated facial laceration in a healthy patient is the best match for primary wound closure with sutures.

The main idea is that primary closure with sutures works best for wounds that are clean, have little to no contamination, and are in tissue with good blood supply so edges can be approximated securely. A clean, uncomplicated facial laceration in a healthy patient fits this perfectly: the face heals well because of abundant blood flow, and precise edge alignment with sutures gives excellent cosmetic and functional results with a low risk of infection when the wound is properly irrigated and debrided.

In contrast, a puncture wound on the plantar surface that is contaminated should not be closed primarily. The contamination and the location increase the risk of trapping debris and bacteria under the sutures, which can lead to infection or abscess; such wounds are typically irrigated, debrided, and either left open or closed after delayed primary closure once the infection risk has diminished.

An avulsion with tissue loss on the hand also isn’t suited to primary closure because the tissue defect and potential dead space make simple suturing inadequate; these injuries usually require more complex reconstruction, grafts, or staged closure to restore function and appearance.

So the option describing a clean, uncomplicated facial laceration in a healthy patient is the best match for primary wound closure with sutures.