Suture and Staples removal

SUTURE/ STAPLES REMOVAL

• IN MOST CASES, sutures and staples applied to surgical wounds are removed in 7 to 10 days.

• Inform patient that they might feel slight discomfort, such as a pulling sensation or stinging.

• Wear clean gloves and remove the dressing.

• Inspect the wound for edge approximation and signs of infection 

1. If after the longest adequate time, wound hasn’t approximated, it means it never will until underlying cause for the same is treated and so, sutures are removed nevertheless.

2. Serous discharge from a wound is generally not problematic

• Remove the gloves, wash your hands, and put on sterile gloves. 

• Clean the suture line with an antimicrobial solution before and after suture or staple removal.

• Always first remove alternate sutures/ staples. Assess the wound for dehiscence; if none occurs, remove the remaining sutures.

To remove a plain interrupted suture

REQUIREMENTS: Sterile gauze piece, Ethanol, Blade and Forceps

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• Gently grasp the knot with forceps (by your non-dominant hand) and raise it slightly.  

  Place the curved tip of the suture scissors/ blade (in dominant hand) directly under the knot as close as possible to the skin 

• Gently cut the suture and pull it out with the forceps with the direction of pull being ‘over’ the wound rather than ‘away’ from the wound (to prevent any tension on the wound).

  
  

  

• Forceps may not be available (not recommended but it may sometimes be the case) so hold the knot up with one hand and cut the suture directing the force such that the sharp edge faces away from your other hand (to prevent injury to self).

To remove staples

REQUIREMENTS: Staple remover, Sterile gauze piece, Ethanol

• Place the lower jaw of the remover under a staple. Squeeze the handles by depressing your thumb completely to close the device. This bends the staple in the middle and pulls the edges out of the skin.

  
  

  
  
  

  
  

  
  

• Do not pull up the staple removal device.

• Gently move the staple away from the incision site when both ends are visible. Hold the staple remover over a gauze piece or sharps container relax pressure on the handles, and let the staple drop into the container.

After suture or staple removal

• Count the number of sutures/ staples removed and re-confirm with patient (to ensure none is left).

• Apply sterile wound strips to prevent dehiscence. 

NOTE:

• If dehiscence occurs, cover the wound with sterile gauze saturated with sterile 0.9% sodium chloride solution and immediately notify a senior.

• Don’t remove remaining sutures or staples if dehiscence occurs.

   

  REFERENCE VIDEO LINKS:

• Removal of plain interrupted suture: https://youtu.be/Hg-bSb1FLTA 

• Removal of surgical staples: https://youtu.be/OatwWz1k2s8 (** DO NOT HOLD THE REMOVED STAPLES IN YOUR HAND)

Written by our guest authors - Anveshi Nayan and Neha Kumari

Illustrations by Anveshi Nayan

#Ae(ONE)INTERN