Surgical staples are specialized metal fasteners used instead of traditional sutures to close large incisions or wounds quickly and securely following an operation. Nurses are routinely authorized to perform this task, which is considered a standard post-operative procedure. This practice is governed by strict protocols and specific clinical conditions that must be met before any staples are taken out.
Which Nurses Are Authorized
The authority for a nurse to remove surgical staples stems primarily from their professional scope of practice, which is defined by state Nurse Practice Acts and specific institutional policies. Registered Nurses (RNs) are universally authorized to perform staple removal as it is a fundamental skill taught and competency-tested during their initial training. Their comprehensive education prepares them to conduct the necessary pre-removal wound assessment and exercise the clinical judgment required for the procedure.
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) are also commonly authorized to remove staples. This authorization may depend on the complexity of the wound or specific state regulations regarding the delegation of skilled tasks. If the wound assessment reveals complications, LPNs/LVNs may be required to seek supervision from an RN or a physician before proceeding.
Staple removal requires clinical assessment and typically cannot be delegated to unlicensed assistive personnel (UAPs) or Certified Nursing Assistants (CNAs). These support staff members are trained to assist with basic care activities but lack the formal education necessary for wound evaluation. This distinction ensures the patient’s healing status is properly evaluated by a licensed professional before removal takes place.
Prerequisites for Staple Removal
Removing surgical staples follows a careful process built around patient safety and proper tissue healing. The first requirement is a current, written medical order from the operating physician or authorized provider. This order must clearly specify the number of staples to be removed and the designated date or time frame for the procedure.
The most important step is the thorough assessment of the wound site immediately prior to removal. The nurse must ensure that the incision edges are well-approximated, meaning they are neatly joined together without gaps. They will closely check for any signs of dehiscence, which is the partial or complete separation of the wound layers, indicating inadequate healing.
The assessment also focuses on identifying signs of infection, which would necessitate delaying the removal. The nurse looks for localized redness, swelling, increased pain, or purulent drainage from the incision line. If these signs are present, the nurse must immediately stop the process and consult the physician for new instructions.
Standard healing timelines dictate that staples remain in place for 7 to 14 days, depending on the anatomical location. Incisions on areas with high movement or tension (e.g., the back, abdomen, or joints) often require two weeks or longer to ensure deep tissue strength. Incisions on the face or scalp, which have a better blood supply, may be ready for removal in five to seven days.
The nurse uses this knowledge and visual assessment to determine if the tissue is robust enough to withstand the loss of mechanical support. The environment where the procedure takes place also requires consideration (hospital room, clinic, or patient’s home). Maintaining a clean field and proper lighting are necessary to minimize the risk of introducing bacteria into the wound tract. This careful preparation ensures the physical act of removal is done safely.
The Proper Removal Procedure
Once the clinical assessment confirms the wound is ready, the nurse gathers the specialized equipment. The primary instrument is a sterile, disposable staple remover, designed to bend the metal fastener in the center and lift it away from the skin. The nurse first cleans the incision site gently with an antiseptic solution to prepare the area.
The removal technique involves carefully sliding the lower jaw of the remover underneath the center of the staple. The nurse then squeezes the handles firmly, causing the top of the staple to bend upward and out of the skin without pulling or tearing the tissue. Each staple is removed individually, and the nurse observes the wound’s integrity after each removal to ensure the incision edges remain together.
After all staples have been removed, the nurse performs a final cleaning of the area to remove any crusting or dried blood. It is standard practice to apply sterile adhesive strips, called Steri-Strips, across the incision line to provide additional support to the healing wound. These strips minimize tension on the new scar tissue and are left in place until they naturally fall off.
The final step involves providing detailed instructions to the patient about post-procedure care of the site. Patients are advised to keep the area clean and dry and to monitor for any delayed signs of separation or infection over the next few days. This education empowers the patient to participate in their wound recovery process.