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.
    1. Doff gloves, perform hand hygiene, and prep supplies!
    2. 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.
    3. Open the antiseptic swabs (most have 3 that come in a pack).
    4. Clean the surgical site with an antiseptic swab and discard.
    5. Let the site completely dry.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    1. Remove the rest of the staples.
    2. Note (remember) the numerical amount of staples you removed.
    3. Clean the sites and let them dry.
    4. Place steri-strips.
    5. 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.
    6. Educate the patient to let the steri-strips fall off naturally (takes about 10 days). Showers are best until the strips fall off.
    7. Discard the staples in the SHARPS BOX (or how your hospital requires).
    8. Doff gloves
    9. Perform hand hygiene
    10. 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

    Can RN remove staples?
    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. more
    Can an RN intubate?
    Yes, most registered nurses can be trained to intubate. In fact, many learn intubation techniques at some point, such as during ACLS training. However, one issue that arises is how often they perform intubations. more
    Can RN draw ABG?
    An ABG can be performed by a doctor, nurse practitioner, physician assistant, registered nurse, and/or respiratory therapist. more
    Can an RN delegate to another RN?
    Rationale: Only a licensed nurse can delegate. In addition, because they are responsible, they need to provide direction, determine who is going to carry out the delegated responsibility, and assist or perform the responsibility him/herself, if he or she deems that appropriate under the given circumstances. more
    Can RN declare death?
    California Correctional Health Care Services (CCHCS) shall permit Registered Nurses (RNs) to make the determination and pronouncement of patient death under specified circumstances. This policy applies only to determining the irreversible cessation of circulatory and respiratory function. more
    Can RN mix medications?
    The appropriately trained and competent licensed registered nurse (RN) and licensed practical nurse (LPN) may compound or reconstitute medications for a specific patient as directed by an authorized health care practitioner with prescriptive authority. more
    Can RPN become RN?
    If you're in the nursing field, Ontario college nursing bridging programs may be the right option for you; programs provide the education needed for Registered Practical Nurses (RPNs) to get BScNs and become Registered Nurses (RNs), for internationally trained nurses to get certified for work in Ontario and for RNs to more
    Is it a RN or an RN?
    The rule of thumb is usually A before consonants and AN before vowels. BUT -- when consonants make vowels sounds, you use AN, and when vowels make consonant sounds, use A. So, the real way to tell is to listen to the sound. In this case, RN makes a vowel sound, so it would be "an" RN. more
    Are RN nurses rich?
    In the United States overall, the average registered nurse salary is $82,750 and the median (50th percentile) is $77,600. California, with RN salaries averaging $124,000, is the highest-paying state for nurses as of May 2021 (according to the BLS). $63,460 lower than California's average is South Dakota, at $60,540. more
    Can RN draw blood?
    Drawing blood is one of the skills required of a registered nurse. While there are phlebotomists that work at the hospital, you can't count on them to always be there when your patient needs an important lab test done. more
    Does rn take blood?
    Most RNs receive on-the-job training in phlebotomy rather than taking a certification course. Spending a day with the phlebotomy or IV team is all that's usually required to draw blood in the hospital if you're an RN. more

    Source: www.registerednursern.com

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