Suture Removal
The goal of this procedure is to remove skin sutures from a healed wound without damaging newly formed tissue. The timing of suture removal depends on the shape, size, and location of the sutured incision; the absence of inflammation, drainage, and infection; and the patient’s general condition. For a sufficiently healed wound, sutures are typically removed 7 to 10 days after insertion.
Techniques for removal depend on the method of suturing, but all require sterile technique to prevent contamination. Although sutures usually are removed by a doctor, in many facilities, a nurse may remove them on the doctor’s order.
Equipment
Waterproof trash bag ▪ adjustable light ▪ clean gloves, if the wound is dressed ▪ sterile gloves ▪ sterile forceps or sterile hemostat ▪ normal saline solution ▪ sterile gauze pads ▪ antiseptic cleaning agent ▪ sterile curve-tipped suture scissors ▪ povidone-iodine sponges ▪ Optional: butterfly or regular adhesive strips, compound benzoin tincture or other skin protectant.
Prepackaged, sterile suture-removal trays are available.
Preparation of Equipment
Gather 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 properly to avoid reaching across the sterile field or the suture line when disposing of soiled articles. Form a cuff on the bag by turning down the top to provide a wide opening and prevent contamination of instruments or gloves by touching the bag’s edge.
Implementation
If your facility allows you to remove sutures, check the doctor’s order to confirm the details of this procedure.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Check for patient allergies, especially to adhesive tape and povidone-iodine or other topical solutions or medications.
Tell the patient that you’re going to remove the stitches from his wound. Assure him that this procedure typically is painless, but that he may feel a pulling sensation as the stitches come out. Reassure him that because his wound is healing properly, removing the stitches won’t weaken the incision.
Provide privacy, and position the patient so he’s comfortable without placing undue tension on the suture line. Because some patients experience nausea or dizziness during the procedure, have the patient recline if possible. Adjust the light to have it shine directly on the suture line.
Perform hand hygiene. If the patient’s wound has a dressing, put on clean gloves and carefully remove the dressing.2,3,4
Discard the dressing and the gloves in the waterproof trash bag.
Observe the patient’s wound for possible gaping, drainage, inflammation, signs of infection, and embedded sutures. Notify the doctor if the wound has failed to heal properly. The absence of a healing ridge under the suture line 5 to 7 days after the incision indicates that the line needs continued support and protection during the healing process.
Establish a sterile work area with all the equipment and supplies you’ll need for suture removal and wound care.
Perform hand hygiene and put on sterile gloves and open the sterile suture removal tray if you’re using one.2,3,4
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
