Steps on Remove Surgical Staples

Cuts Closed With Staples: Care Instructions

Overview

A cut can happen anywhere on your body.

The doctor used staples to close the cut. Staples easily and quickly close a cut, which helps the cut heal.

Sometimes a cut can injure tendons, blood vessels, or nerves. If the cut went deep and through the skin, the doctor may have put in a layer of stitches below the staples. The deeper layer of stitches brings the deep part of the cut together. These stitches will dissolve and don't need to be removed. The staples in the upper layer are what you see on the cut.

You may have a bandage. You will need to have the staples removed, usually in 7 to 14 days.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

How to Remove Surgical Staples

As a nurse you will be removing surgical staples. This article will detail how to remove surgical staples in a patient after surgery.

Why do patients have surgical staples? To close a wound of some type, which is most commonly a surgical site. While working on a post-op floor for vascular surgery patients, I encountered surgical staples daily. Most of the patients I provided care to had carotid endarterectomies, amputations, or received surgery for peripheral vascular disease. So, surgical staples are common.

What supplies are needed to remove surgical staples? Before removing surgical staples, ALWAYS read over your hospital’s policy on how they want you to do this skill. Some hospitals require you wear sterile gloves, while others only require clean gloves. In the video I made about how to remove surgical staples, I wore sterile gloves and this is how it will be presented in this article.

Supplies:

Staple Remover Kit (includes staple extractor and gauze)

Dressing change tray (I prefer to use this because it contains the sterile drape to keep the supplies sterile while removing the staples along with sterile gloves and antiseptic swabs…very handy for cleaning the site before and after staple removal)

Steri-strips

Demonstration on How to Remove Surgical Staples

Steps on Remove Surgical Staples

ALWAYS pay attention to if the physician wants you to remove ALL or just every other staple. If every other staple is ordered to be removed, the patient will have the other staples removed at the first post-operative visit in the office.

Explain the procedure to patient, address concerns, and obtain their verbal consent to remove the staples. Does this hurt the patient? No, not usually. They may feel tugging or pulling while you remove the staples. However, if ordered, you can offer pain medication prior to removal because the site is still tender since it is a surgical site, if needed.

Gather supplies!

Perform hand hygiene and don CLEAN gloves to remove the old surgical dressing, if present.

After doing this, assess the site and ask yourself?

Is there infection present (excessive redness, warm to the touch, hard, oozing foul looking drainage or a smell)?

Does the surgical site look like it is NOT ready to have the staples removed? Are there open areas around the staples that look like the skin has NOT “fused” back together?

If you can answer YES to any of those questions, notify the physician BEFORE proceeding with the staple removal.

Doff gloves, perform hand hygiene, and prep supplies!

Open dressing change tray and set-up supplies!The sterile gloves and drape should be at the top of the dressing change tray after you open it….carefully grab them and place them down in your work area.

Open the sterile drape first (watch the video above to know how to properly open the sterile drape)

Then open and DROP the staple remover kit supplies and steri-strips onto the sterile drape along with the antiseptic (you can keep it in the tray if you choose or place them on the drape). I prefer to keep them in the tray because there is a chance that once their opened they will leak onto the drape, which will contaminate the field.

Don the sterile gloves

Open the antiseptic swabs (most have 3 that come in a pack).

Clean the surgical site with an antiseptic swab and discard.

Let the site completely dry.

Time to remove the staples. For this tutorial, the physician’s order says to remove ALL the staples. HOWEVER, first we will remove EVERY OTHER staple starting with the 2nd staple.

WHY? A complication of removing surgical staples is WOUND DEHISCENCE….this is where the surgical site opens up prematurely before wound healing can occur. By removing every other staple first, this will help decrease this from happening. Before we remove the other staples, steri-strips will be in place to protect the site.

Start removing the staples at the 2nd staple. To do this, place the mouth of the staple remover under the staple. Then depress the handle of the staple remover, and it will remove the staple. Do NOT pull or try to help the staple remover remove the staple….it will do this on its own.

TIP: After removing each staple, be sure to place them in gauze and don’t forget to count them (document it too). WHY place the staples in a gauze? This will help prevent the staples from getting lost and cutting someone…..remember this is considered a sharp.

Continue removing every other staple. Then clean the areas of where you removed the staples with a new antiseptic swab and let the site dry.

Place steri-strips on the places you removed the staples.

Cut the steri-strips so about ¾ of an inch is on each side of the incision (or whatever the physician prefers or your hospital protocol dictates).

In addition, space each strip 1/8 of an inch.

NOTE: While placing the steri-strip, gently press one side down and then gently press the other side down. Do NOT pull or create tension while placing them…..steri-strips are very strong and could tear the skin if too much tension is created during placement.

Remove the rest of the staples.

Note (remember) the numerical amount of staples you removed.

Clean the sites and let them dry.

Place steri-strips.

Optional: cover the site with a dressing if the site is at risk for friction. Is the site in the groin where the jeans will rub against it OR is the site at risk for moisture? If you place a dressing, EDUCATE the patient how to change it and given them supplies to do so.

Educate the patient to let the steri-strips fall off naturally (takes about 10 days). Showers are best until the strips fall off.

Discard the staples in the SHARPS BOX (or how your hospital requires).

Doff gloves

Perform hand hygiene

Document: number of staples you removed, how the patient tolerated the procedure, complications (if applicable), how the site looked, education you provided to the patient

More nursing skills

Suture or Staple Questions

Is this your symptom?

This topic covers common questions about sutures (stitches) and staples

Some Basics...

Stitches and staples are used to keep wounds together during healing.

They need to be removed within 4-14 days. The specific removal date depends on the location of the stitches or staples. Removal should not be delayed.

When Should Sutures or Staples Get Removed?

Here are some general guidelines for when stitches or staples should be removed.

Face: 4-5 days

Neck: 7 days

Scalp: 7-10 days

Chest, stomach, and back: 7-10 days

Arms and back of hands: 7 days

Legs and top of feet: 10 days

Fingers and toes: 10-14 days

Palms and soles: 12-14 days

Over a joint: 12-14 days

Is It Normal for the Skin to Feel Numb Around the Sutures or Staples?

There are three reasons why the skin near sutures or staples might feel numb.

Local Anesthesia: the doctor may have injected the skin to make it numb. This way there is no pain when the doctor puts in sutures or staples. How long this lasts depends on what type of local anesthesia was used. Numbness can last from 1-8 hours.

Numbness from the Cut Itself: some people have numbness after getting a cut. There is numbness just along the edges of the wound. This is from cutting nearby tiny nerves at the same time. Numbness can last 1-3 weeks. These tiny nerves will grow back in 2-3 weeks. The numbness will go away.

Nerve Injury: sometimes a cut can be deep enough that it cuts a larger nerve. Numbness that is not just around the wound and that lasts more than 8 hours is a clue. For example, numbness that does not go away, just on one side of a cut finger may mean there has been a digital nerve injury. A person with a possible nerve injury should see his or her doctor.

When to Call for Suture or Staple Questions

Call Doctor or Seek Care Now

Severe pain in the wound

Bleeding that won't stop after 10 minutes of direct pressure

Stitch (or staple) came out early and wound has re-opened

Wound looks infected (spreading redness, pain) and large red area

Wound looks infected (spreading redness, pain) and on face

Red streak runs from the wound

You feel weak or very sick

You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Stitch (or staple) came out early and wound is still closed

Overdue to have stitches (or staples) removed

Wound looks infected (spreading redness, pus)

Pain or tenderness of the wound worsens after 48 hours

You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Numbness goes beyond the wound edges and lasts more than 8 hours

You have other questions or concerns

Self Care at Home

Stitched or stapled wound with no other problems

Care Advice

Stitched or Stapled Wound

What You Should Know:

Stitches and staples need to be removed within 4-14 days. The specific removal date depends on the location of the stitches or staples. Removal should not be delayed.

You should take care of stitched or stapled wounds at home.

Here is some care advice that should help.

Treatment - Normal Stitched or Stapled Wound:

Keep the wound dry for the first 24 hours. Use a sponge bath, if needed.

After 24 hours, it is OK to take a short shower.

Avoid direct pressure of water on the wound. Gently pat the wound dry with a towel.

Apply a small amount of petroleum jelly (Vaseline) on the wound daily. You can buy this at the store. This helps protect the wound and limits scarring. Exception: if your doctor recommended an antibiotic ointment, use that instead.

Clean the wound with warm water 1 time per day or if it gets dirty.

Change the wound dressing if it gets wet or dirty.

You do not need a dressing after the edges of the wound have closed. This most often happens after 48 hours. You may still need a dressing to stop stitches from catching on your clothing.

Avoid baths and swimming until the sutures are removed. Water can interfere with healing.

When Should Stitches or Staples Be Removed? Your doctor will have told you when to get your stitches removed. Here are some general guidelines for when stitches or staples should be taken out:

Face: 4-5 days

Neck: 7 days

Scalp: 7-10 days

Chest or stomach: 7-10 days

Arms and back of hands: 7-10 days

Legs and top of feet: 10 days

Back: 10 days

Palms and soles: 12-14 days

Over a joint: 12-14 days

What Happens If You Leave Stitches (or Staples) in Too Long?

Get your stitches out at the right time.

Stitches that are left in too long can leave skin marks and sometimes cause scarring. Delays also make it harder to take the stitches out.

What Happens If Stitches (or Staple) Fall Out Early?

If the stitches or staples come out early, the wound might open up.

You can reinforce the wound with tape or butterfly adhesive bandages (Band-Aids).

Call your doctor.

Treatment - After Your Stitches (or Staples) Have Been Removed:

Protect the wound from injury during the next month.

Avoid sports that could re-injure the wound. If you must play a sport, put tape on the wound before playing.

Let the scab fall off on its own. Do not try to remove it.

Pain Medicine:

You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).

They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.

Use the lowest amount of a drug that makes your pain feel better.

Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.

Read the instructions and warnings on the package insert for all medicines you take.

Call Your Doctor If:

Wound looks infected

Fever

Pain or tenderness at the wound site worsens after 48 hours

Stitches or staples come out early

You think you need to be seen

You get worse

Preventing Scars

What You Should Know:

Scarring is a natural part of the healing process after a cut or wound.

Serious injuries and larger wounds are more likely to have scarring.

Most cuts that need stitches, staples, or skin glue will have some scarring.

Some people are more likely than others to get scars.

Here is some care advice that should help.

Prevention:

Be certain to get the stitches removed when your doctor told you to. If you leave them in too long, they can leave marks.

Avoid getting sunburn on the wound area for 2 months.

Avoid re-injuring this area.

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 8/8/2022 1:00:41 AM Last Updated: 1/13/2022 1:00:51 AM