A patient with grossly contaminated wound presents 12 hours after an accident. His wound should be managed by -

Any wound can be closed by primary suture or delayed primary suture or left open to heal by secondary closure Primary suture is suitable for clean wounds & selected contaminated wounds after thorough wound toileting & debridement Delayed primary closure is done for heavily contaminated wounds wounds in which wound toileting has been delayed for 6-8 hrs. But these were the indications earlier. Now the recent approach is: if the blood supply to the wound is adequate and bacterial invasion is absent, wounds can be safely closed anytime following proper debridement & irrigation. if there is established infection and tissue of doubtful viability has been left in situ, then the wound is left open and re-explored after 48 hrs. If there is no infection, and the doubtful viable tissue is now healthy, the deep tissues can be repaired & the wound closed. If however there is further necrosis & infection the wound is again debrided & left open.