Taking out sutures and staples

Attention

• If taken out too soon — wound can open up again
• If left in too long — can be scarring, infection
• See Table 8.2 for suture removal times, staples usually removed after 7–10 days 

What you need

• Sterile dressing pack
• Disposable gloves
• Normal saline
• For sutures — fine pointed/curved suture-cutting scissors or sterile stitch-cutter blade
• For staples — staple removing device
• Adhesive strips for any gaping in wound
• Non-stick dressing and sticky tape, if needed

What you do

• Check
• Wound healed and closed
• Signs of infection
• Where sutures/staples are, how many. Check post op/surgeons instructions
• Not absorbable/dissolvable sutures
• Lay out dressing pack and equipment
• Wash hands, put on disposable gloves
• Clean healed wound with normal saline, remove any dry or dead skin on sutures/staples
• Sutures
• Hold knot securely with forceps
• Cut suture close to skin on side away from knot, then pull out in direction of knot — Figure 7.67
• Do not pull dirty part of suture through skin
• If sutures small or close to skin — stitch-cutter blade may be easier to use

• Staples
• Slide bottom lip of staple removal device between staple and skin — Figure 7.68
• Bring 2 lips of staple removal device together — Figure 7.69. Staple bends and opens points of staple in skin — Figure 7.70
• Gently lift out staple, put into dressing tray

• First remove every second suture/staple, even if all to be removed
• If wound starts to gape — leave rest of sutures/staples in. Clean and close with adhesive strips. Leave for another 1–2 days
• After sutures/staples removed — check approximation and healing of skin
• Put adhesive strips across wound if needed
• Dress if needed
• Wound care education