Wounds that heal primarily by secondary intention typically involve which of the following?

Wounds that heal primarily by secondary intention typically involve granulation tissue formation. This process occurs when a wound is left open to heal naturally rather than being closed with sutures or other methods. The body forms granulation tissue as part of the healing process, which is characterized by the growth of new connective tissue and small blood vessels. This tissue helps fill the wound and ultimately supports skin regeneration.

In secondary intention healing, the wound heals from the bottom up, which means that the granulation tissue must develop and mature before the epithelial cells can migrate across the wound bed to cover it. This method of healing is often seen in larger, deeper, or contaminated wounds where direct closure is not feasible or safe, necessitating a longer healing time and increased vulnerability to infection.

Other options such as direct suturing and surgical intervention immediately pertain to primary intention healing, where wounds are closed directly to promote faster recovery. Healing without scarring is also more characteristic of primary intention, as secondary intention healing usually results in a more noticeable scar due to the greater tissue loss and the healing process that occurs.