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

1. VERIFY the physician’s order. 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.
2. 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.
3. Gather supplies!
4. 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.

5. Doff gloves, perform hand hygiene, and prep supplies!
6. 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
7. Open the antiseptic swabs (most have 3 that come in a pack).
8. Clean the surgical site with an antiseptic swab and discard.
9. Let the site completely dry.
10. 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 2^nd 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.
11. Start removing the staples at the 2^nd 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.
12. 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.
13. 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.

14. Remove the rest of the staples.
15. Note (remember) the numerical amount of staples you removed.
16. Clean the sites and let them dry.
17. Place steri-strips.
18. 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.
19. Educate the patient to let the steri-strips fall off naturally (takes about 10 days). Showers are best until the strips fall off.
20. Discard the staples in the SHARPS BOX (or how your hospital requires).
21. Doff gloves
22. Perform hand hygiene
23. 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

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