PIEDMONT ACCESS TO HEALTH SERVICES, INC.
Policy Number:
01-10-019
SUBJECT:
Skin and Staple Removal
EFFECTIVE DATE:
3/2010
REVIEWED/REVISED: 01/19/2011
______________________________________________________________________________
POLICY:
Skin staples or clips may be used instead of standard sutures to close lacerations or surgical wounds.
Because they can secure a wound more quickly than sutures, they may substitute for surface sutures when
cosmetic results aren’t a prime consideration, such as in abdominal closure. When properly placed, staples
and clips distribute tension evenly along the suture line with minimal tissue trauma and compression,
facilitating healing and minimizing scarring. Because staples and clips are made from surgical stainless steel,
tissue reaction to them is minimal. Usually, physicians remove skin staples and clips, but some facilities
permit qualified nurses to perform this procedure.
PROCEDURE:
1.
2.
Equipment-Prepackaged, sterile, disposable staple or clip extractors are available.
a. Waterproof trash bag
b. Adjustable light
c. Sterile gauze pads
d. Sterile staple or clip extractor
e. Antiseptic cleaning agent
f. Sterile cotton-tipped applicators
g. Optional: butterfly adhesive strips or Steri-Strips, compound benzoin tincture or other
skin protectant.
Preparation of equipment
Assemble all equipment in the patient’s room. Check the expiration date on each sterile
package, and inspect for tears. Open the waterproof trash bag, and place it near the
patient’s bed. Position the bag to avoid reaching across the sterile field or the wound
when disposing of soiled articles. Form a cuff by turning down the top of the bag to
provide a wide opening, then preventing contamination of instruments or gloves by
touching the bag’s edge.
Implementation
a. If your facility allows you to remove skin staples and clips, check the practioner’s order
to confirm the exact timing and details for this procedure.
b. Check for patient allergies, especially to adhesive tape and povidone-iodine or other
topical solutions or medications.
c. Explain the procedure to the patient. Tell him that he may feel a slight pulling or tickling
sensation but little discomfort during staple removal. Reassure him that because his
incision is healing properly, removing the supporting staples or clips won’t weaken the
incision line.
a.
3.
01-10-019 Skin and Staple Remover
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d. Provide privacy, and place the patient in a comfortable position that doesn’t place
undue tension on the incision. Because some patients experience nausea or dizziness
during the procedure, have the patient recline if possible. Adjust the light to shine
directly on the incision.
e. Wash your hands thoroughly.
f. If the patient’s wound has a dressing, put on clean gloves and carefully remove it.
Discard the dressing and the gloves in the waterproof trash bag.
g. Assess the patient’s incision. Notify the practitioner of gaping, drainage, inflammation,
and other signs of infection.
h. Establish a sterile work area with all the equipment and supplies you’ll need for
removing staples or clips and for cleaning and dressing the incision. Open the package
containing the sterile staple or clip extractor, maintaining asepsis. Put on sterile gloves.
i. Wipe the incision gently with sterile gauze pads soaked in an antiseptic cleaning agent
or with sterile cotton-tipped applicators to remove surface encrustations.
j. Pick up the sterile staple or clip extractor. Then, starting at one end of the incision,
remove the staple or clip. (See Removing a staple.) Hold the extractor over the trash
bag, and release the handle to discard the staple or clip.
k. Repeat the procedure for each staple or clip until all are removed.
l. Apply a sterile gauze dressing, if needed, to prevent infection and irritation from
clothing. Then discard your gloves.
m. Make sure the patient is comfortable. According to the practitioner’s preference,
inform the patient that he may shower in 1 or 2 days if the incision is dry and healing
well.
n. Properly dispose of solutions and the trash bag, and clean or dispose of soiled
equipment and supplies according to your facility’s policy.
4.
Documentation
a. Record the date and time of staple or clip removal, number of staples or clips removed,
appearance of the incision, dressings or butterfly strips applied, signs of wound
complications, and the patient’s tolerance of the procedure.
SIGNATURES:
_______________________________________________
Medical Director
___ / ___ /______
Date
_______________________________________________
Director of Clinical Operations
___ / ___ /______
Date
01-10-019 Skin and Staple Remover
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