Suture and Staple Removal

Suture and Staple Removal

wound closure strips/ medical tape can be placed if wound seperation is notes

WOUND CLOSURE DEVICES

Skin glue, used either alone or over sutures, is associated with a decreased risk of Surgical Site Infections (SSIs)

Suture and Staple Removal: General timing

Do not remove unless instructed to. Provider preference may be earlier or later for removal.

The normal time frame for staple removal is within 5 to 7 days, based on the stage of healing and the extent and location of surgery.Common time frames for suture removal include:

• 3 to 5 days for the face;
• 7 to 10 days for the scalp, chest, fingers, hand, and legs; and
• 10 to 14 days for the back, forearm, and foot.

Sutures that are removed too soon can place the wound at risk for reopening.Staples and sutures that are left in too long can also increase the risk of site infection and scarring

If the site is seeping yellow exudate or looks infected, notify the provider before removing sutures or staples

Removing Staples, Sutures, and Steri Strips

(5:47 minutes)

Staple Removal

• Obtain a sterile staple remover kit.
• Don clean gloves.
• Cleanse the staples and incision area with sterile antiseptic swabs
• Place BOTH lower tips of the staple extractor under the first staple
• Close the handles all the way to cause the extractor to depress the center of the staple and both ends of the staple to be bent upward simultaneously, exiting the dermal layer.
• Lift the staple away from the skin surface as soon as both ends of the staple are visible and hold the staple tightly until it is positioned over the disposal site.
• Release the handle and discard the staple.
• Remove every other staple by repeating the above steps, then remove the remainder if incision is intact without seperation.
• Check line and verify all staples removed.
• Count how many staples are removed and document in the patient’s record.

Suture Removal

• Obtain a sterile suture removal kit.
• Don clean gloves
• Cleanse the sutures and incision area with sterile antiseptic swabs per the organization’s practice.
• Place sterile gauze several inches from the suture line. Grasp the sterile scissors in the dominant hand and the forceps in the nondominant hand.
• Grasp a knot of suture with the forceps and gently pull it up while slipping the tip of the scissors under the suture near the skin.
• Carefully snip the suture as close to the skin as possible at the end distal to the knot.
• Grasp the knotted end with the forceps and pull the suture through from the other side in one continuous, smooth action.
• Place the removed suture on the gauze.
• Remove every other suture by repeating the above steps, then remove the remainder if incision is intact.
• Check line and verify all sutures are removed.

Cleaning Wound After Removal

Placing Medical Tape (Steri-Strips)

• You may need to apply medical tape strip to healing wounds after suture / staple removal:

• Remove a few sutures / staples at a time and replace them with tape.
• Do not remove all sutures / staples from the wound at once, as the wound can separate.

• Continue same process until all sutures / staples have been removed.

Placing Medical Tape (Steri-Strips)

• Apply skin adhesive to the surrounding skin of wound per provider order / organization’s practice.
• Do not allow adhesive to enter the wound!

• Dry for minimum of 1 minute (until tacky).

• Cut tape strip to desired length, with an overlap of 2 to 3 cm (1 inch) on each side of the wound.

• Remove end tab from paper backing of tape strip. Grasp tape strip with forceps and remove rest of backing by gently pulling it straight up with the forceps.
• Do not let tape strip twist to either side during removal as it can curl the tape.

• Place first tape strip piece perpendicular to the wound middle on one side of wound.

• Approximate wound edges and apply the second half of the tape strip.
• Do not pull edges together!
• Run finger along tape strip to help set adhesive.

• Place additional tape strips halfway between the previous tape and the ends of the wound. Continue to apply tape until the wound is sufficiently closed.

• Leave small gaps between tape strips to ensure ventilation along the wound.

Thank you

Reference: Elsevier Staple and Suture Removal: https://point-of-care.elsevierperformancemanager.com/skills/619/extended-text?skillId=GN_37_2&virtualname=vuebl-tnnashville#scrollToTop accessed 9/5/2023