Surgical staples are small pieces of medical-grade metal used to close incisions or deep lacerations on the head. They are deployed rapidly and provide strong closure, which is useful for the scalp due to its rich blood supply and frequent tension. Unlike office staples, surgical staples are designed to hold skin edges together temporarily for proper healing. Since they are non-absorbable, removal is a necessary medical procedure performed by a trained healthcare provider (doctor, nurse, or physician’s assistant). Attempting removal at home is highly discouraged due to the risk of infection, improper wound closure, and damage to healing tissue.
Determining the Optimal Time for Removal
The timing for removing scalp staples balances ensuring the wound has gained sufficient strength with minimizing the risk of scarring. The scalp’s excellent blood supply generally promotes faster healing compared to other body areas. For most uncomplicated scalp incisions, the optimal window for staple removal is between seven and ten days after placement.
Removing staples too early (before seven days) can cause the wound edges to separate (dehiscence) because the underlying tissue lacks adequate tensile strength. Delaying removal beyond ten days increases the risk of “railroad track” scarring, where staple impressions become permanent, or tissue grows around the metal. A healthcare provider assesses the wound for proper healing, such as well-approximated edges and the absence of redness or discharge, before scheduling removal.
Patient-specific factors can influence this timeline, potentially pushing removal closer to the ten-day mark or later. Patients with impaired healing (e.g., diabetes, those on immunosuppressive drugs, or older individuals) may require staples to remain longer. The severity of the original wound and the tension on the incision line are also considered to prevent the wound from reopening.
The Professional Removal Procedure
The removal of surgical staples uses a specialized, single-use instrument called a staple remover or staple extractor, which is distinct from common household tools. This device is engineered to gently bend the staple in the middle, causing the prongs to lift cleanly out of the skin. Using makeshift tools like tweezers or pliers is unsafe because they pull the staple directly out, risking pain and tearing the newly healed skin.
The procedure begins with the professional cleaning the area with an antiseptic solution to minimize bacteria introduction. The lower jaw of the staple remover is positioned under the center of the first staple at one end of the incision. Squeezing the handles completely causes the device’s top portion to push down on the staple’s crossbar.
This pressure changes the staple’s shape, effectively releasing the prongs from the skin. The staple is then lifted straight out in the direction it was originally placed, minimizing trauma to the wound. Patients typically report a slight tugging or pinching sensation, but the procedure is generally not painful and does not require local anesthetic. The provider repeats this action for each staple, often placing them onto a clean piece of gauze.
Essential Post-Removal Care
Immediately after staple removal, the healthcare provider cleans the incision site again with an antiseptic solution. Depending on the wound’s appearance, small adhesive strips, such as Steri-Strips, may be applied across the incision line for extra support. These strips help maintain the wound’s integrity as it gains strength and usually fall off naturally within a week or two.
Proper hygiene is essential for the next several days to mitigate the risk of infection. Patients are typically allowed to shower and gently wash their hair the same day staples are removed, as the wound has usually completed epithelialization. The scalp should be washed gently with mild soap, rinsed thoroughly, and patted dry with a clean towel, avoiding harsh scrubbing over the incision.
Monitoring the wound for signs of complication is important during the post-removal period. Patients should watch for increased redness spreading beyond the incision line, worsening swelling, purulent drainage, or a fever, which indicate a potential infection requiring immediate medical attention. To minimize scarring, patients should avoid excessive tension or trauma to the healing area for several weeks, and protect the area from sun exposure once fully healed.