SUTURE REMOVAL – Nurse Info - Bibliobazar Digi Books

SUTURE REMOVAL – Purpose, Principle, Usual Timing, Factors Affecting, Types, General Instructions, Preliminary Assessment, Preparation of Patient and Environment, Procedure, Equipment and Post-Procedure Care

UPDATED 2024

Suture
removal is a process removing materials used to secure wound edges or body
parts together from healed wound without damaging newly formed tissue

The timing
of suture removal depends on the shape, size and location of the sutured
incision

The sutures
may be removed by the surgeons or by the surges regarding to the tropical
customs. In all cages, the surgeon gives the written order for the removal of
the sutures

PURPOSE

Sutures are
foreign bodies and if they are not removed they are capable of causing local
inflammation

PRINCIPLE

Never pull the visible portion of the
suture through underlying tissue
Suture line is cleansed before and
after suture removal
No part of the stitch which is above
the skin level enter and contaminate the tissue under the skin

USUAL TIMING

Scalp and free: 2-5 days
Abdominal wounds: 7-10 days
Lower limbs: 10-14 days

FACTORS AFFECTING THE SUTURE REMOVAL

Type of suture
Wound bedding

TYPES

Removing staples: to remove staples,
the nurse simply inserts the tips of the staple remover under each wire
staples. Squeezes are center of the staple with the tips, freeing the staples
from the skin
Intermittent suture: the surgeon tied
each individual suture made in the skin
Continuous suture: it is the series
of sutures with only two knots
Retentions suture: they are placed
deeply than skin sutures

GENERAL INSTRUCTIONS

Confirm the doctor’s order for the
removal of the sutures
The suture removal is done in
conjunction with the dressing change
When removal interrupted in sutures,
alternate one are removed first
Suture material left beneath the skin
acts as a foreign body and clients the inflammatory response
If wound dehiscence occurs during the
removal of sutures, inform the surgeon immediately
After removing the sutures, even if
the wound is dry, the small dressing is applied for the day or two to prevent
infection
If wound discharge occurs, the
patient should be instructed to contact the surgeon
Abdominal belts or many tailed
bandages may be applied as the abdomen after removal of abdominal sutures in
obese patients to prevent wound dehiscence and evisceration

PRELIMINARY ASSESSMENT

Check the physician’s order
Assess the general candidates of the
patient
Check the specific precautions of any
Check the consciousness of the
patient and his ability to follow instructions

PREPARATION OF PATIENT AND ENVIRONMENT

Explain the procedure to the patient
Provide privacy, if needed
Clean the area before and after the
procedure

EQUIPMENT

Water proof thrash bag
Adjustable light
Clean gloves, if the wound is dressed
Sterile gloves
Sterile forceps
Normal saline solution
Sterile gauze pads
Antiseptic cleaning agent
Sterile curve tipped suture scissors
Povidone-iodine sponges
Optional adhesive butterfly strips
and compound benzoin tincture or other skin protectant

PROCEDURE

To remove the interpreted sutures,
grasp the suture at the knot with a toothed forceps and pull it gently to
expose the portion of the stitch under the skin
Cut the suture with a sharp scissors
between the knot and the skin on one side either below the knot or opposite the
knot. The pull the thread out of one piece
The suture which is already above the
skin should not be drawn under the skin. After removal of sutures, every suture
should be examined for completeness. The number of suture’s shower be countered
before and after removal
Mattress intercepted sutures have no
threads underlying the skin. The visible part of the suture opposite the knot
should be cut and the suture is removed by putting in the direction of the knot
If a continuous suture is applied, it
is cut through, close at each skin orifice on one side and the cut sections are
removed through the opposite side by gentle traction