Suture and Staple Removal

If the wound edges are separated or signs of infection are present, the wound has not healed properly. Notify the physician because the sutures or staples may need to remain in place, and/or other wound care may need to be initiated.

 
Getting Ready

  1. Check physician's order for suture or staple removal. Assess suture line for healing.
  2. Provide privacy, and position patient to expose suture line under direct lighting.
  3. Perform hand hygiene, and place cuffed refuse disposal bag nearby.
  4. Prepare sterile field with dressing change supplies.
  5. Open sterile suture removal tray or staple extraction tray. Slide contents onto prepared field, maintaining sterility of inside surface of wrapper or tray.
  6. Open sterile antiseptic swabs, and place on inside surface of tray. Open sterile glove package, exposing cuffed ends.
  7. Apply clean gloves. Carefully remove dressing. Discard dressing and gloves in bag.

Inspect wound.
  • Apply sterile gloves, if required by policy.
  • Cleanse sutures or staples and healed incision with antiseptic swabs.
Removing the Staple or Suture
Remove staples.

  1. Place lower tips of staple extractor under first staple, and carefully close handles.
  2. When both ends of staple are visible, move it away from skin and over refuse bag. Release handles of staple extractor, allowing staple to drop into refuse bag.
  3. Repeat until all staples have been removed.

Remove intermittent sutures.

  1. Place gauze a few inches from suture line. Grasp scissors in dominant hand and forceps in nondominant hand.
  2. With forceps, gently pull up knot while slipping tip of scissors under suture near skin. Snip suture as close to skin as possible.
  3. With forceps at knot, pull suture through from side. Place removed suture on gauze.
  4. Repeat steps a through c until every other suture has been removed.
  5. Observe healing. If wound response to suture removal is appropriate, repeat steps a through c until all sutures have been removed. If there is any doubt, stop and notify physician.

Remove continuous sutures, including blanket stitch sutures.

  1. Place gauze a few inches from suture line. Grasp scissors in dominant hand and forceps in nondominant hand.
  2. Snip first suture close to skin at end distal to knot. Snip second suture on same side.
  3. Grasp knotted end, and gently pull to remove suture. Place it on gauze.
  4. Repeat steps  in consecutive order until entire line has been removed.
  5. Inspect incision site to ensure that all sutures have been removed and to spot trouble areas. Gently wipe suture line with antiseptic swab.

    * Apply Steri-Strips™ if separation is greater than one stitch or one staple wide.
    * Apply tincture of benzoin or Skin Prep™ on each side of suture line. Let dry.

Cut Steri-Strips to allow strips to extend 4 to 5 cm on each side of incision.

  1. Remove backing, and apply Steri-Strips across incision.
  2. Tell patient to take showers rather than baths, according to physician's preference.
  3. Apply light dressing or expose wound to air if no clothing will touch suture line. Instruct patient about applying own dressing if it will be needed at home.
  4. Discard all used supplies; route reusable items for resterilization. Perform hand hygiene.
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