Suture and Staple Removal – OSCE Guide

This removal of suture and staple guide provides a step-by-step approach to the removal of both sutures and staples in an OSCE setting.

Indications

Indications for removing sutures or staples include the planned removal of non-absorbable sutures or skin staples following wound healing after surgical or traumatic injuries.

Recommended time for removal

Suture removal timing depends on the anatomical site and expected healing rate:

Face: 5 days
Eyelids: 5 days (3 days for low-tension wounds and up to 7 days for high-tension wounds)
Neck: 5 to 7 days
Scalp: 7 days
Trunk and upper extremities: 7 to 10 days
Lower extremities: 8 to 10 days
Digits, palm, and sole: 10 to 14 days

Contraindications

Possible contraindications for removing sutures or staples include:

Signs of wound dehiscence (gaping)
Active infection or increased exudate
Incomplete healing or poor tissue integrity

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Gather equipment

Gather the appropriate equipment:

Gallipots or indented tray*
Low-lint swabs or medical foam*
Disposable forceps*
Sterile field*
Waste disposal bag*
Non-sterile gloves
Disposable apron
0.9% sodium chloride solution
Sterile scissors
Stitch cutter or staple remover
Sterile adhesive skin strips
Hypoallergenic tape
Appropriate wound dressing
Universal disinfectant wipes
Documentation tools and traceability labels

* These items of equipment may be found in a sterile dressing pack

Introduction

Review the patient’s surgical notes and dressing plan.

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.

Don PPE, including a disposable apron.

Introduce yourself to the patient, including your name and role.

Confirm the patient’s name and date of birth.

Briefly explain what the procedure will involve using patient-friendly language: “I’d like to remove your sutures/staples, which were used to help your wound heal. You may feel a slight pulling or pinching sensation as each one is taken out, but it’s quick and well tolerated.”

Gain consent to proceed with removing the sutures/staples.

Check if the patient has any allergies (e.g. latex, adhesives).

Offer analgesia depending on the patient and wound site.

Adequately expose the suture/staple site for the procedure.

Position the patient for comfort and ease of removal. If a bed is available, the patient can lie down for the procedure (this is sometimes preferable, particularly if the patient is prone to vasovagal syncope).

Support the area for comfort, if necessary, by placing a pillow or rolled-up towel to keep it steady and reduce strain.

Preparation

1. Clean a suitable trolley with a universal disinfectant wipe.

2. Wash your hands and don gloves and a disposable apron.

3. Using an aseptic technique, open the dressing pack using the corners and place the equipment, such as sterile scissors, stitch cutters or staple removers, onto the sterile field. Arrange items on the sterile field, using the sterile waste bag in the dressing pack as a barrier if needed.

4. Pour the 0.9% sodium chloride solution into a gallipot or indented tray.

5. Attach the waste bag to the trolley.

Suture removal

1. Don gloves (if not worn already) and remove the dressing, disposing of it into the clinical waste bag.

2. Remove and dispose of gloves.

3. Wash your hands and don new gloves.

4. Examine the wound and surrounding skin. Seek senior advice if any issues are present before proceeding with suture removal.

5. Clean the wound using swabs and 0.9% sodium chloride, removing dried blood or exudate.

Clean in a smooth, single motion, then dispose of the swab. Repeat this with a new swab each time until the wound is clean.

6. Hold the forceps in your non-dominant hand and the scissors or blade in your dominant hand.

7. Grasp the knot of the suture with the forceps and gently pull it upward.

8. Slide the blade under the opposite side of the suture, as close to the skin surface as possible, and cut the suture just before the knot.

Never cut both ends, as part of the suture will remain in the skin.

9. Still grasping the knot, pull the suture upward and free of the entry point using a smooth, continuous action.

10. Place the removed suture in a gallipot or sterile gauze to confirm that the number of sutures removed matches the number inserted.

11. Repeat the process, removing alternate sutures first and continually observing the wound response.

If wound breakdown or dehiscence occurs, stop, apply a sterile dressing, and notify a senior.

12. After all sutures are removed, check the patient’s comfort and apply adhesive strips if needed.

13. Cover the wound with an appropriate dressing.

Staple removal

1. Don gloves (if not worn already) and remove the dressing, disposing of it into the clinical waste bag.

2. Remove and dispose of gloves.

3. Wash your hands and don new gloves.

4. Examine the wound and surrounding skin. Seek senior advice if any issues are present before proceeding with suture removal.

5. Clean the wound using swabs and 0.9% sodium chloride, removing dried blood or exudate.

Clean in a smooth, single motion, then dispose of the swab. Repeat this with a new swab each time until the wound is clean.

6. Hold the staple remover in your non-dominant hand and slide the flat lower bar under the staple so that the “V” groove sits directly beneath it.

7. Squeeze the handles together, bending the staple in the middle and lifting the ends up and out of the skin.

If the skin is tight, use your other hand to gently support the tissue as the staple is removed.

8. Place the removed staple in a gallipot or sterile gauze to confirm that the number of staples removed matches the number inserted.

9. Repeat the process, removing alternate staples first and continually observing the wound response.

If wound breakdown or dehiscence occurs, stop, apply a sterile dressing, and notify a senior.

10. After all staples are removed, check the patient’s comfort and apply adhesive strips if needed.

11. Cover the wound with an appropriate dressing.

To complete the procedure…

Explain to the patient that the procedure is now complete.

Thank the patient for their time.

Dispose of your PPE and other clinical waste into an appropriate clinical waste bin and sharps bin.

Wash your hands.

Document the details of the suture or staple removal in the patient’s notes, including:

The patient’s details: full name, date of birth and unique identification number
The date and time of suture or staple removal
How many sutures or staples were removed
The condition of the wound post-removal
If any complications were encountered during the procedure
The type of dressing applied post-removal
If any analgesia was needed
Your name, designation, and signature

Editor

Dr Jamie Scriven

References

deLemos DM, Singer AJ. Skin laceration repair with sutures. UpToDate. 2025. Available from: [LINK].
The Royal Marsden NHS Foundation Trust. 18.2 Suture Removal. The Royal Marsden Hospital Manual of Clinical and Cancer Nursing Procedures. 2025. Available from: [LINK].
Ford C, Hill B. A guide to removing sutures. British Journal of Nursing. 2024. Available from: [LINK].
The Royal Marsden NHS Foundation Trust. 18.3 Clip Removal. The Royal Marsden Hospital Manual of Clinical and Cancer Nursing Procedures. 2025. Available from: [LINK].
Ford C, Hill B. A guide to removing surgical staples. British Journal of Nursing. 2024. Available from: [LINK].