Medical staples are small metal fasteners used by surgeons to quickly and securely close large surgical incisions or wounds. Whether these fasteners dissolve or require removal depends entirely on the material and location. The majority of visible staples on the skin do not dissolve, distinguishing external metal fasteners from the absorbable polymers used internally to support healing tissue.
Understanding Surgical Fasteners
Surgical fasteners are divided into two main categories based on their composition. External staples, visible on the skin’s surface, are typically made from non-absorbable metals like stainless steel or titanium. These materials are chosen for their high tensile strength and inert nature, providing strong wound closure with minimal reaction from the body. They maintain their structure and must be physically removed once the wound has healed.
Internal staples, used to reconnect tissue and organs, are often made from non-absorbable metals, but absorbable options also exist. For instance, in gastrointestinal or lung surgery, surgeons may utilize polymers designed to break down over time. These absorbable fasteners eliminate the need for a second procedure to retrieve the support structure. The selection between metal and polymer depends on the tissue type and the required duration of temporary support.
The Process of External Staple Removal
Since external skin staples do not dissolve, their removal is a standard, non-surgical procedure performed once the incision has healed enough to withstand normal tension. Removal timing is variable, generally occurring between 5 and 14 days after surgery, though some areas, like vertical abdominal incisions, may require up to 21 days. The specific schedule is determined by the incision’s location, size, and the patient’s healing rate.
The removal process uses a specialized medical tool called a staple extractor. The extractor’s lower jaw slides under the staple, and squeezing the handles causes the top part to push down on the middle. This action bends the metal ends outward, lifting the fastener cleanly out of the skin. Patients typically feel a slight tugging or pinching sensation rather than pain during the quick procedure.
In some cases, the provider may remove every second staple initially to test the incision’s strength before removing the remainder later. After removal, small adhesive strips, known as Steri-Strips, are often applied across the incision line for extra support. Patients should keep the area clean and allow the Steri-Strips to fall off naturally, usually within one to three weeks.
How Absorbable Materials Break Down
The disappearance of internal, absorbable surgical materials, whether sutures or polymer staples, occurs through a predictable biological process. The primary mechanism for the most common synthetic absorbable polymers, such as those made from polyglycolic acid (PGA) or polylactic acid (PLA), is a chemical reaction called hydrolysis. In this process, water molecules present in the body’s tissues penetrate the material and gradually break down the long polymer chains into smaller, soluble fragments. These fragments are then safely absorbed, metabolized, and eliminated by the body over time.
A different mechanism, enzymatic degradation, is responsible for the breakdown of natural materials, such as catgut sutures, where the body’s enzymes directly metabolize the foreign substance. The rate of this absorption is carefully calibrated by manufacturers and varies widely depending on the material’s composition and thickness. For example, some synthetic materials provide support for a few weeks and are completely absorbed within two to three months, while others, like Polydioxanone (PDS), can provide extended support and take up to six months to fully disappear. This controlled degradation allows the material to hold the healing tissues together for the necessary period before dissolving. Surgeons select these materials specifically to match the healing time required by the internal tissue they are closing.