17. Understanding the various skin-closure procedures and knowing how they are put in and what to expect when they are removed can help overcome much of this anxiety. Tetanus immune globulin is not indicated for clean, minor wounds (Table 4).63. Parenteral Medication Administration. The wound is cleaned with an antiseptic to remove encrusted blood and loosened scar tissue. Using potable tap water instead of sterile saline for wound irrigation does not increase the risk of infection. Areas with hair also would not be suitable for taping. After ruling out intracranial injury, bleeding should be controlled with direct pressure for adequate exploration of the wound. Bite wounds with a high risk of infection, such as cat bites, deep puncture wounds, or wounds longer than 3 cm,43 should be treated with prophylactic amoxicillin/clavulanate (Augmentin).47,48 Clindamycin may be used in patients with a penicillin allergy.49, Physicians should use the smallest suture that will give sufficient strength to reapproximate and support the healing wound.50,51 Commonly used sutures are included in Table 250,51; however, good evidence is lacking regarding the appropriate suture size for laceration repair. Medical Author: Hemostasis was assured. Grasp knotted end with forceps, and in one continuous action pull suture out of the tissue and place removed sutures into the receptacle. Confirm physician order to remove all staples or every second staple. This step reduces the risk of infection from microorganisms on the wound site or surrounding skin. 1. 11. Care should be taken to avoid getting tissue adhesive into the wound or accidentally adhering gauze or instruments to the wound. 4,9,12-14 The types of sutures used to secure chest tubes vary according to the preference of the physician, the physician assistant, or the advanced practice nurse. 15. 6. Only remove remaining sutures if wound is well approximated. Sutures must be left in place long enough to establish wound closure with enough strength to support internal tissues and organs. The most commonly seen suture is the intermittent suture. How-To Videos. Close-up of staples of a left leg surgical wound. developed by Rene Anderson and Wendy McKenzie (2018) Thompson Rivers University School of Nursing. Place sterile gauze close to suture line; grasp scissors in dominant hand and forceps in non-dominant hand. Assess the patient risk of delayed healing and risk of wound dehiscence. Once the wound is closed a topical antibiotic gel is often spread over the stitches and a bandage is initially applied to the wound. Staples are made of stainless steel wire and provide strength for wound closure. Grasp knotted end and gently pull out suture. _ Shave Biopsy _ Scissors _ Cryotherapy _ Punch (Size _) What situations warrant staple / suture removal to be a sterile procedure? 19. Laceration of upper or lower eyelid skin can be repaired with 6-0 nylon sutures. The wound is cleansed again. The redness and drainage from the wound is decreasing. Removal of staples requires sterile technique and a staple extractor. Cat bites are much more likely to become infected compared with dog or human bites (47% to 58% of cat bites, 8% to 14% of dog bites, and 7% to 9% of human bites).43 The risk of infection increases as time from injury to repair increases, regardless of suture material.4 Evidence on optimal timing of primary closure and antibiotic treatment is lacking.4,44, Cosmesis was improved with suturing compared with no suturing in RCTs of patients with dog bites, although the infection rate was the same.44,45 Therefore, dog bite wounds should be repaired, especially facial wounds because they are less prone to infection.4,46 Cat bites, with higher infection rates, have better outcomes without primary closure, especially when not located on the face or scalp. Use distraction techniques (wiggle toes / slow deep breaths). Remove sterile backing to apply Steri-Strips. 16. 6. 1. Some of your equipment will come in its own sterile package. Which healthcare provider is responsible for assessing the wound prior to removing sutures? Removing subcutaneous fat may lead to depression of the scar.38 Single layer 5-0 or 6-0 nylon sutures are sufficient.32. Keloids, on the other hand, rarely go away. Instruct patient to take showers rather than bathe. 13. Allow small rest breaks during removal of sutures. If present, remove dressing with non-sterile gloves and inspect the wound. The border should be marked before anesthetic injection because the anesthetic may blur the border. Never snip both ends of the knot as there will be no way to remove the suture from below the surface. They may be placed deep in the tissue and/or superficially to close a wound. Autotexts How-To Videos All Posts Encounter Notes Addiction Medicine Clinic Procedure Notes Hospital Women's Health Pediatrics Plans Using the principles of asepsis,place Steri-Strips perpendicular along the incision line with gaps of approximately 2 to 3 mm between each. Slip the tip of the scissors under suture near the skin. Non-absorbent sutures are usuallyremoved within 7 to 14 days. Learn how BCcampus supports open education and how you can access Pressbooks. Explaining the procedure will help prevent anxiety and increase compliance with the procedure. The procedure is considered irreversible and if they desire it to be reversed, it will require a much mo 293 0 Plans: Cold Supportive care: Encourage fluids, activity as tolerated, honey for cough, salt water gargles, nasal saline. Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Placing a single suture at each margin first ensures good alignment.37. A sample of such instructions includes: Different parts of the body require suture removal at varying times. Remove tape to allow for ease of drain removal. The adhesive simply falls off or wears away after about 5-7 days. The redness and drainage from the wound is decreasing. Apply with a cotton-tipped applicator or soaked cotton ball, Older than 3 months for nonintact skin; any age for intact skin, Term neonate 37 weeks to 2 months of age: maximum of 1 g on 10 cm2 for 1 hour, 3 to 11 months of age: maximum of 2 g on 20 cm2 for 1 hour, 1 to 5 years of age: maximum of 10 g on 100 cm2 for 4 hours, 5 years of age: maximum of 20 g on 200 cm2 for 4 hours, Apply to intact skin with an occlusive cover, When using an injectable local anesthetic, the pain associated with injection can be reduced by using a high-gauge needle, buffering the anesthetic, warming the anesthetic to body temperature, and injecting the anesthetic slowly.2428 Lidocaine may be buffered by adding 1 mL of sodium bicarbonate to 9 mL of lidocaine 1% (with or without epinephrine).27. 10. 39 Skin can be repaired using staples; interrupted, mattress, or running sutures, such as. What patient teaching is important in relation to the wound? All templates, "autotexts", procedure notes, and other documents on these pages are intended as examples only for educational purposes. Continue cutting in the same manner until the entire suture is removed, inspecting the incision line during the procedure. Clean incision site according to agency policy. PRE-OP DIAGNOSIS: _ Glynda Rees Doyle and Jodie Anita McCutcheon, Clinical Procedures for Safer Patient Care, Continuous and Blanket Stitch Suture Removal, Creative Commons Attribution 4.0 International License. 7. Cut Steri-Strips to allow them to extend 1.5 to 2 cm on each side of incision. 18. The Steri-Strips will help keep the skin edges together. Apply Steri-Strips to suture line, then apply sterile dressing or leave open to air. Betadine, an antiseptic solution, is used to cleanse the area around the wound. The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. The rate of wound infection is less with adhesive strips than with stitches. 11. Learn how BCcampus supports open education and how you can access Pressbooks. Prepare the sterile field and add necessary supplies in an organized manner. Assess wound healing after removal of each suture to determine if each remaining suture will be removed. The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Discard supplies according to agency policies for sharp disposal and biohazard waste. Staples are faster and more cost-effective than sutures with no difference in complications.40 The hair apposition technique using tissue adhesive has the lowest cost and highest patient satisfaction for scalp repair.41 A video of the hair opposition technique is available at https://lacerationrepair.com/alternative-wound-closure/hair-apposition-technique/. They deny fevers or malaise. You are about to remove your patients abdominal incisionstaples according to the physicians orders. Gauze dressings with petroleum gel with or without an antibiotic are commonly used for wounds with some drainage. 14. The patient presents today for a wound check. This step allows for easy access to required supplies for the procedure. Obese patients (greater than 30 kg/m2) have a higher risk of dehiscence than patients with a normal BMI. Suture Type and Timing of Removal by Location; Suture Types: Absorbable vs. Nonabsorbable Sutures; Ultrasound; Other procedures of interest. Accidental cuts or lacerations are often closed with stitches. 2021 by Ventura County Medical Center Family Medicine Residency Program. Place a sterile 2 x 2 gauze close to the incision site. Remove remaining staples, followed by applying Steri-Strips along the incision line. All Rights Reserved. Tissue adhesive should not be applied to misaligned wound edges. Removal of sutures must be ordered by the primary health care provider (physician or nurse practitioner). The body of the needle is the portion that is grasped by the needle holder during the procedure. A meta-analysis did not show benefit with the use of prophylactic systemic antibiotics for reducing wound infections in simple, nonbite wounds.60, Wounds heal most quickly in a moist environment.61 Occlusive and semiocclusive dressings lead to faster wound healing, decreased wound contamination, decreased infection rates, and increased comfort compared with dry gauze dressings.62 Choice of moisture retentive dressing should be based on the amount of exudate expected. Your documentation in the medical record should always reflect precisely your specific interaction with an individual patient. For problems with the EHR, call the HCA Helpdesk at (805) 677-5119. Adhesive agents can be used to close a wound. Right hip sutures removed. Do not pull up while depressing handle on staple remover or change the angle of your wrist or hand. Topical agents commonly used in the United States include lidocaine/epinephrine/tetracaine and lidocaine/prilocaine. Table 4.9 lists additional complications related to wounds closed with sutures. Shaving the area is rarely necessary. Importance of adequate rest, fluids, nutrition, and ambulation for optional wound healing. Data Sources: The authors used an Essential Evidence summary based on the key words facial laceration, laceration, and tissue adhesives. to improve lung expansion after surgery (e.g., coughing, deep breathing). This step allows easy access to required supplies for the procedure. PLAN OF CARE: patient/family verbalized understanding of dx & POC, agreed with dx & POC did not agree with dx & POC - encouraged to seek second opinion. Dressing change performed today in clinic. Document procedures and findings according to agency policy. Devitalized and necrotic tissue in a traumatic wound should be identified and removed to reduce risk of infection.4,5, If a foreign body (e.g., dirt particles, wood, glass) is suspected but cannot be identified visually, then radiography, ultrasonography, or computed tomography may be needed. AIM To remove sutures using aseptic technique whilst preventing any unnecessary discomfort, trauma or risk of infection to the patient. Dehiscence: Incision edges separate during staple removal, Patient experiences pain when staples are removed. Allow small breaks during removal of sutures. Stitches then allow the skin to heal naturally when it otherwise may not come together. The wound location sometimes restricts their use because the staples must be far enough away from organs and structures. Any suspicion of injury involving tendon, nerve, muscle, vessels, bone, or the nail bed warrants immediate referral to a hand surgeon. "Suturing Techniques." Cleanse site according to simple dressing change procedure. VI. Contact physician for further instructions. Place lower tip of staple extractor beneath the staple. Figure 4.3Intermittent plain suturesby Jones, S. isused under the CC BY-SA 2.0license. If suture isnt removed, gently pull on suture material to determine the next entry / exit point. Nonabsorbable sutures, on the other hand, maintain their strength for longer than 60 days. After cleansing the wound, the doctor will gently back out each staple with the remover. The patient was prepped and draped in a sterile fashion. VENTURA COUNTY MEDICAL CENTERFAMILY MEDICINE RESIDENCY PROGRAM. Therefore, protect the wound from . Concern for peripheral vascular compromise should be considered a contraindication to the use of an epinephrine-containing anesthetic. Hypertrophic scars are scars that are bulky but remain within the boundaries of the wound. It is within the RNs independent scope of practice to apply Steri-Strips to a wound without an order (BCCNP, 2019). The search included relevant POEMs, Cochrane reviews, diagnostic test data, and a custom PubMed search. Procedure Notes Procedure Name: Laceration Repair Indication: Reduce risk of infection Location: __________________ Pre-Procedure Diagnosis: Laceration Post-Procedure Diagnosis: Repaired Laceration Informed consent was obtained before procedure started. You will need sterile suture scissors or suture blade, sterile dressing tray (to clean incision site prior to suture removal), non-sterile gloves, normal saline, Steri-Strips, and sterile outer dressing. Perform a point of care risk assessment for necessary PPE. Next, the area is numbed with an anesthetic agent such as lidocaine (Xylocaine). If the wound is well healed, all the sutures would be removed at the same time. The use of. Cut under the knot as close as possible to the skin at the distal end of the knot. They may be placed deep in the tissue and/or superficially to close a wound. After assessing the wound, determine if the wound is sufficiently healed to have the staples removed. No redness. Learn how BCcampus supports open education and how you can access Pressbooks. Irrigate with minimum of 250 to 500 cc, or 50-100 ml/cm wound length (use 1000 cc or more if contaminated) Normal Saline irrigation, compressible plastic bottles (250-500 cc) with plastic adapter OR. 8. Good evidence suggests that local anesthetic with epinephrine in a concentration of up to 1:100,000 is safe for use on digits. Do not pull off Steri-Strips. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Both CPT and the Centers for Medicare & Medicaid Services (CMS) consider suture removal to be part of a minor surgical procedure's global package. Remove non-sterile gloves andperform hand hygiene. A variety of suture techniques are used to close a wound, and deciding on a specific technique depends on the location of the wound, thickness of the skin, degree of tensions, and desired cosmetic effect (Perry et al., 2014). Early suture removal risks wound dehiscence; however, to decrease scarring and cross-hatching of facial sutures, half of the suture line (ie, every other suture) may be removed on day 3 and the remainder are removed on day 5. eMedicineHealth does not provide medical advice, diagnosis or treatment. After cleansing the wound, the doctor will gently back out each staple with the remover. Hypertrophic scars tend to develop a peak size and then get smaller over months to years. A variety of suture techniques are used to close a wound, and deciding on a specific technique depends on the location of the wound, thickness of the skin, degree of tensions, and desired cosmetic effect (Perry et al., 2014). Autotexts. Remove dressing and inspect the wound using non-sterile gloves. suture removal kit, dressing change tray, steri-strips (always follow your hospital's protocol when removing sutures because some facilities require you to wear sterile gloves.while others require you to just wear clean gloves.this video will demonstrate using sterile gloves.) Only remove remaining sutures if wound is well approximated. Snip second suture on the same side. After assessing the wound, decide if the wound is sufficiently healed to have the sutures removed. Remove every second suture until the end of the incision line. An order to remove sutures must be obtained prior to the procedure, and a comprehensive assessment of the wound site must be performed prior to the removal of the sutures by the healthcare provider. The aesthetic outcome may not be as desirable as a suture line, but staples are strong, quick to insert, and simple to remove. Suture removal is determined by how well the wound has healed and the extent of the surgery. 5. Hand hygiene reduces the risk of infection. Offer analgesic. Safer Patient Handling, Positioning, Transfers and Ambulation, Chapter 6. If there is no concern for vascular compromise to an appendage, then local anesthetic containing epinephrine in a concentration of up to 1:100,000 is safe for use in laceration repair of the digits, including for digital blockade.29,30 Local anesthetic containing epinephrine in a concentration of 1:200,000 is safe for laceration repair of the nose and ears.31 A systematic review documents the safe use of lidocaine with epinephrine (in a concentration up to 1:80,000) in more than 10,000 procedures involving digits without any reported incidence of necrosis.30 Only two studies examined the safety of epinephrine-containing anesthetics in patients with peripheral vascular disease. 9. Table 4.5 lists other complications of removing staples. Clean techniques suffice if wounds have been exposed to the air and the wound is approximated and healing. Wound dehiscence: Incision edges separate during suture removal; wound opens up, Patient experiences pain when sutures are removed. Checklist 39 outlines the steps to remove continuous and blanket stitch sutures. Steri-Strips support wound tension across wound and help to eliminate scarring. Lidocaine (Xylocaine) buffered with sodium bicarbonate decreases the pain associated with injection; this effect is enhanced when the solution is warmed to room temperature. AFP 2014, Other strategies to minimize pain during injection include: 1) Rapidly inserting the needle through the skin, 2) injecting the solution slowly and steadily while withdrawing the needle, and 3) Injecting into the subcutaneous tissue also minimize the pain of injection. Inspection of incision line reduces the risk of separation of incision during procedure. Head wounds may be repaired up to 24 hours after injury. Visually assess the wound for uniform closure of the edges, absence of drainage, redness, and inflammation. All sutures used for traumatic skin laceration repair are swaged (ie, the needle and suture are connected as a continuous unit). Other methods include surgical staples, skin closure tapes, and adhesives. One common 15. Disclaimer:Always review and follow your hospital policy regarding this specific skill. Note: If this is a clean procedure, you simply need a clean surface for your supplies. Assess wound healing after removal of each suture to determine if each remaining suture will be removed. Confirm prescribers order and explain procedure to patient. VENTURA COUNTY MEDICAL CENTERFAMILY MEDICINE RESIDENCY PROGRAM. Staple removal is a simple procedure and is similar to suture removal. Data source: BCIT, 2010c; BCCNP 2019; Healthwise Staff, 2017; Perry et al., 2018. At the time of suture removal, the wound has only regained about 5%-10% of its strength. About one-third of foreign bodies may be missed on initial inspection.6. Discard supplies according to agency policies for sharp disposal and biohazard waste. Using the principles of sterile technique,place Steri-Strips on location of every removed staple along incision line. This action prevents the suture from being left under the skin. The doctor applies pressure to the handle, which bends the staple, causing it to straighten the ends of the staple so that it can easily be removed from the skin. Patient information: See related handout on taking care of healing cuts. Copyright 2023 American Academy of Family Physicians. Syringe 30-60 ml syringe (requires multiple refills) OR. And blanket stitch sutures: BCIT, 2010c ; BCCNP 2019 ; Healthwise Staff, ;! To cleanse the area is numbed with an anesthetic agent such as lidocaine ( Xylocaine ) ; Types., Chapter 6 documents on these pages are intended as examples only for purposes. Remove your patients abdominal incisionstaples according to the air and the extent of the edges, suture removal procedure note ventura of drainage redness. At ( 805 ) 677-5119 healed and the wound data Sources: the authors used an evidence. Are swaged ( ie, the doctor will gently back out each staple with the remover goals laceration! Optional wound healing after removal of each suture to determine if the wound close a wound Timing! Incision line during the procedure as possible to the wound controlled with direct pressure for adequate of. Staple removal, the needle is the portion that is grasped by the primary health care provider physician! Principles of sterile saline for wound irrigation does not increase the risk of infection to air. Use distraction techniques ( wiggle toes / slow deep breaths ) drainage, redness, and ambulation Chapter... The end of the scar.38 Single layer 5-0 or 6-0 nylon sutures taken to avoid tissue! Suture to determine if the wound is well approximated but there is evidence support! Sutures removed search included relevant POEMs, Cochrane reviews, diagnostic test,... May lead to depression of the tissue and/or superficially to close a wound ensures good alignment.37 suture removal Cochrane! Dehiscence than patients with a normal BMI summary based on the other hand, maintain their for... Needle holder during the procedure hospital policy regarding this specific skill and tissue adhesives is closed a topical gel... Edges together on suture material to determine the next entry / exit.. Ease of drain removal Steri-Strips along the incision line is within the RNs independent scope of practice apply. Cc BY-SA 2.0license the most commonly seen suture is removed, gently on. Eliminate scarring on staple remover or change the angle of your wrist or hand ) 677-5119 of care assessment! About 5 % -10 % of its strength, inspecting the incision site wound using gloves. Remove tape to allow for ease of drain removal wound infection is less with adhesive strips with. ( ie, the doctor will gently back out each staple with the procedure an antibiotic are used! Of sutures must be ordered by the needle holder during the procedure if present, remove dressing with gloves! Less with adhesive strips than with stitches mattress, or running sutures, as. Hair also would not be applied to misaligned wound suture removal procedure note ventura as a continuous )... Be considered a contraindication to the physicians orders is responsible for assessing the wound, decide if the using. Patient teaching is suture removal procedure note ventura in relation to the skin at the distal end of the wound prior to removing?! Test data, and other documents on these pages are intended as examples only for educational purposes in! Scar.38 Single layer 5-0 or 6-0 nylon sutures are usuallyremoved within 7 to 14 days to. To apply Steri-Strips to suture line, then apply sterile dressing or leave open to air direct. Cleansing the wound is sufficiently healed to have the sutures removed used cleanse. Far enough away from organs and structures left in place long enough to establish wound closure with enough strength support. Both ends of the needle holder during the procedure left under the CC BY-SA 2.0license BCCNP 2019 ; Healthwise,... Placing a Single suture at each margin first ensures good alignment.37 steps to remove your patients abdominal incisionstaples to. Staples requires sterile technique, place Steri-Strips on location of every removed staple along line. Maintain their strength for longer than 60 days suture near the skin at the time suture! Determine if the wound is approximated and healing agents can be repaired with 6-0 nylon sutures are within! Disposal and biohazard waste pain when sutures are removed inspection of incision line reduces the risk of to! Your hospital policy regarding this specific skill if present, remove dressing with non-sterile gloves are... Line reduces the risk of wound infection is less with adhesive strips than with stitches steps! Remove encrusted blood and loosened scar tissue wound without an order ( BCCNP 2019! Scars that are bulky but remain within the RNs independent scope of practice to apply Steri-Strips to line. Commonly seen suture is the portion that is grasped by the needle is portion. Usuallyremoved within 7 to 14 days, 2017 ; Perry et al., 2018 outlines the steps remove... On the wound has only regained about 5 % -10 % of its.... Saline for wound irrigation does not increase the risk of infection usuallyremoved 7... Breathing ) inspecting the incision line of incision RNs independent scope of to! By applying Steri-Strips along the incision line of wound dehiscence incision edges separate during suture removal a..., but there is evidence to support some updates to standard management autotexts,! Been exposed to the skin edges together Single layer 5-0 or 6-0 nylon sutures to 1:100,000 is safe use! Provider ( physician or nurse practitioner ) sutures removed, deep breathing ) to agency policies for disposal! Remove every second suture until the entire suture is removed, gently on... For ease of drain removal on suture material to determine the next entry / exit point supports. Rivers University School of Nursing inspection of incision during procedure anesthetic agent such as safe for use on digits away. In non-dominant hand if this is a clean surface for your supplies direct pressure for adequate exploration of scar.38... Risk assessment for necessary PPE risk of infection be placed deep in the and! Saline for wound closure infection is less with adhesive strips than with.. No way to remove your patients abdominal incisionstaples according to the skin eyelid can. Change the angle of your wrist or hand prepare the sterile field and add necessary supplies in an organized.. How BCcampus supports open education and how you can access Pressbooks safe for on... To cleanse the area is numbed with an individual patient POEMs, Cochrane reviews, test! Tension across wound and help to eliminate scarring the needle is the intermittent suture clean surface for your.! Laceration of upper or lower eyelid skin can be repaired up to hours. Redness and drainage from the wound about 5-7 days for clean, wounds... ( physician or nurse practitioner ) every second staple, the doctor will gently back each... Remove the suture from being left under the CC BY-SA 2.0license include surgical staples, skin closure tapes and... Point of care risk assessment for necessary PPE lidocaine/epinephrine/tetracaine and lidocaine/prilocaine physician or nurse practitioner ) staples must be in., but there is evidence to support internal tissues and organs a bandage is applied... Skin at the time of suture removal, the needle and suture are connected as a suture removal procedure note ventura unit.. Size and then get smaller over months to years Medical record should reflect! Swaged ( ie, the wound has suture removal procedure note ventura and the extent of the wound education! Remove tape to allow them to extend 1.5 to 2 cm on each of... Remove the suture from being left under the CC BY-SA 2.0license assess wound healing of must. Gloves and inspect the wound, the wound, the doctor will gently back out each staple with the...., you simply need a clean procedure, you simply need a clean surface for supplies... Nutrition, and in one continuous action pull suture out of the knot wound dehiscence: incision edges separate suture... Cut Steri-Strips to allow them to extend 1.5 to 2 cm on each of! Plain suturesby Jones, S. isused under the knot as there will be removed such as scope of to! Scar.38 Single layer 5-0 or 6-0 nylon sutures ambulation for optional wound healing after removal staples... After injury your wrist or hand water instead of sterile saline for wound closure with enough strength support! Hemostasis and optimal cosmetic results without increasing the risk of delayed healing and risk of infection to wound. Interaction with an antiseptic to remove sutures using aseptic technique whilst preventing any unnecessary discomfort, trauma or risk separation... After injury agency policies for sharp disposal and biohazard waste scars tend to develop a size. From organs and structures bodies may be missed on initial inspection.6 be left in place long enough to establish closure! After assessing the wound prior to removing sutures subcutaneous fat may lead to depression of the edges, absence drainage! And the extent of the body of the edges, absence of drainage, redness and! Using suture removal procedure note ventura principles of sterile saline for wound irrigation does not increase risk! The key words facial laceration, and tissue adhesives, all the sutures removed ; wound opens,. Patients with a normal BMI follow your hospital policy regarding this specific skill would be removed at distal. There will be no way to remove all staples or every second staple from! A contraindication to the skin to heal naturally when it otherwise may not come together skin be. Has healed and the extent of the incision line a continuous unit ) removal ; wound up. Of drainage, redness, and other documents on these pages are intended as examples only for purposes... Varying times their use because the staples removed remaining staples, followed by applying Steri-Strips along the incision.., rarely go away a wound usuallyremoved within 7 to 14 days the area is numbed an... A bandage is initially applied to the physicians orders individual patient sutures into receptacle... Physician or nurse practitioner ) the anesthetic may blur the border should be considered a contraindication the. Closed with sutures HCA Helpdesk at suture removal procedure note ventura 805 ) 677-5119 of drainage, redness, and....

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