Performing Suture and Staple Removal

Techniques and Instruments for Suture and Staple Removal

Wound closure is

often necessary in emergency situations

Properly closing an exposed area of the body prevents

infection and other complication, aids in the healing process, an minimizes scarring

Many different types of wound closure and materials such as

sutures, surgical staples, skin closure tapes, and adhesives

The selection of which types to use when closing a wound or incision depends on the

wound, how much soft tissue is exposed, how clean the wound is, and the assessment of the health care provider

What is Suturing?

the use of any device to close or sew together tissue after an injury or surgery

The most common method in suturing is the use of

specialized thread, or sutures

Sutures are inserted by …

health care provider at the end of a procedure to hold tissues in alignment during the healing process.

What are sutures depending on

based on size, materials, and absorbability. They can be made of diffrent materials and can be absorable or nonabsorbable

Absorbable sutures do not need to be removed and are digested by

tissue enzymes and absorbed by the body tissues

Sutures used to attach tissues beneath the skin are often made of an

absorbable material that disapperars in several days

How many days does absorption usually take after insertion

5-20

Nonabsorbable sutures are used on

skin surfaces where they can easily be removed after an incision heals

Non-absorbable sutures generally remain in place for how many days then be removed

5-6

Nonabsorbable includes material such as

nylon, silk, polyester fiber, and even stainless steel

If sutures remain in skin to long what can happen

they can cause skin irritation and infection

The size of the suture material which is measured by the guage or diameter is stated in terms of

“0” - the more 0s the smaller the gauge

Delicate tissue such as areas on the face and neck would be sutured with

5-0 to 6-0 suture sizes because these finer sutures would leave less scarring

Heavier sutures such as 2-0 would be used for

chest or abdomen

Who determines the type and gauge of sutures to be used

providers

What will suture package label indicate

type, size, length of suture material, and if it is absorbable or nonabsorbable

Stapkes are made of

stainless steel and applied with a surgical stapler

Staples allow for closure of

wounds under high tension, such as on the trunk, extremities, and scalp

Staples are generally used in

delicate tissues or wounds in finely contoured areas

Staples shorten

closure time and are used to rapidly close an incision, which helps decrease the risk of infection

using a specialized set of extractors , staples need to be removed within

4 to 14 days

Sterile tapes are

nonallergenic and available in a variety of widths. used instead of sutures when not much tension will be applied to a wound such as a small facial cut

Cyanoacrylate adhesives

react with water to create an instant, strong, felxible bond

Thoroughly inspect wound to approximate what? and see if there is any?

to approximate the edges and see if the presence or absence of drainage is necessary

Wounds that have crusting blood or exudate will usually need

soaking with saline prior to removal of the sutures or staples

Suture removal kit

suture scissors and forceps

Staple Removal Kit

removal device along with sterile guaze, forceps, sterile gloves, and antiseptic

What should you do with the kit wrappers

use them as a sterile field

How to remove sutures

cut suture with suture scissors below the knot as close to the skin as possible. Remove every other suture an then go back and remove the remaining sutures until all sutures have been removed, observing incision line for separation. Remove suture by pulling the long remaining suture out. Never pull suture material that is outside the skin through the skin

How to remove staples

begin with the second staple of the wound and carefully place the lower tip of the sterile staple remover under the staple. Advance the lower jaw of the staple remover under the staple for removal. Squeeze handle together until they’re completely closed. It’ll bend staple in the middle and pull edges of the staple out of the skin. Do not lift the staple remover when squeezing the handles. Remove every other staple until all are removed while observing the site

When should you stop and notify the provider

if at any time there is gaping, bleeding, or presence of an exudate

Once everything is removed …

clean wound with antiseptic and dress wound as ordered.

Prior to disposal what should you do?

count the number of staples or sutures that were removed

Where do sutures go for disposal

biohazard waste container

Where do staples go to be removed?

in sharps waste container

Butterfly closures

can be used to provide reinforcement of the wound after removal of the sutures or staples depending on the condition and location of the wound