Healing By Second Intention

Healing by second intention: wound healing by union by adhesion of granulating surfaces, when the edges of the wound are far apart and cannot be brought together. Granulations form from the base and sides of the wound toward the surface. Healing by second intention occurs when there is tissue loss, as in extensive burns and deep ulcers. The healing process is more prolonged than in healing by primary intention because large amounts of dead tissue must be removed and replaced with viable cells.

 
First intention is preferable the surgeons agree.
After the initial surprises of vacancy
the shiny white tendon sheaths
the disappointing dullness of bone,
all is covered by the skin’s stretched
complicity, a sutured closure.
 
The scar’s a concealment
a thin red line fading to white
the negative of experience,
something divulged to close friends
never mentioned at parties,
traced by intimate fingers.
 
Second intention can’t help
but infer a compromise.
The bleeding’s the same, the aching
loss, but this unstitched wound
has no skin edges to draw together,  
just an oozing  granulation bed.
 
After a time the gap is filled;
strength is found quickly in collagen
and slowly the white rim of epithelium
draws towards an approximate normality
leaving only the struggle of a twisted line
puckered, like your  lips.
 
Ilse Pedler

If you have any thoughts about this poem, Ilse Pedler would be pleased to hear them.