✂️ Suture & Staple Removal

To establish a standardized process for safely removing sutures and staples while promoting proper wound healing, minimizing infection risk, and ensuring consistent documentation across The Neighborhood Clinic.

Purpose

Sutures and staples should only be removed after provider authorization and once the wound has been assessed for appropriate healing. Staff should evaluate every wound prior to removal and immediately notify the provider if healing appears delayed or complications are identified.

Policy

Medical Assistants may remove sutures or staples only when authorized by the provider and when permitted by state law, clinic policy, and delegated scope of practice.

Removal Workflow

1️⃣ Verify Patient Identity
2️⃣ Review Provider Order
3️⃣ Assess Wound
4️⃣ Gather Supplies
5️⃣ Remove Sutures or Staples
6️⃣ Reassess & Apply Dressing

Required Supplies

Standard Supplies

  • Suture removal kit or staple remover
  • Sterile gauze
  • Gloves
  • Normal saline (if needed)
  • Skin preparation supplies
  • Adhesive bandage or dressing
  • Steri-Strips® if ordered or indicated

Additional Supplies

  • Biohazard waste container
  • Sharps container (when applicable)
  • PPE as indicated
  • Patient education materials

Pre-Removal Assessment

Before removing any sutures or staples, inspect the wound carefully to determine whether removal is appropriate.

  • Verify provider authorization.
  • Inspect wound edges for proper approximation.
  • Assess for redness, swelling, warmth, or drainage.
  • Assess for wound separation.
  • Ask about pain or new symptoms.
  • Review the original procedure date.
  • Confirm the recommended removal timeframe.

Stop and Notify the Provider If:

  • Wound edges have separated.
  • Purulent drainage is present.
  • Excessive redness or swelling is noted.
  • Fever or systemic symptoms are reported.
  • Removal timing appears inappropriate.
  • There are concerns about wound healing.

General Removal Timeframes

Removal timing varies based on wound location, patient factors, and provider preference. Always follow the provider's order when available.

Typical Timeframes

  • Face: 3–5 days
  • Scalp: 7–10 days
  • Chest: 7–10 days
  • Upper Extremities: 7–10 days
  • Abdomen: 10–14 days
  • Back: 10–14 days
  • Lower Extremities: 10–14 days
  • Joints or high-tension areas: 10–14 days or per provider order
Patients with diabetes, compromised immune systems, poor circulation, or delayed wound healing may require longer healing times as determined by the provider.

Suture & Staple Removal Procedure

Once the wound has been assessed and provider authorization has been confirmed, remove sutures or staples using clean technique while minimizing trauma to the surrounding tissue.

1️⃣ Perform Hand Hygiene & Don Gloves
2️⃣ Cleanse Wound if Needed
3️⃣ Remove Every Other Suture (When Appropriate)
4️⃣ Reassess Wound Approximation
5️⃣ Remove Remaining Sutures or Staples
6️⃣ Apply Steri-Strips® or Dressing
Best Practice

For long incisions, the provider may direct removal of every other suture or staple first to assess wound integrity before removing the remaining closure material.

Suture Removal Technique

  • Perform hand hygiene and apply appropriate PPE.
  • Inspect the incision before touching the wound.
  • Cleanse the area if dried drainage or debris is present.
  • Lift the knot gently using sterile forceps.
  • Cut the suture as close to the skin as possible.
  • Pull the suture smoothly through the skin to minimize contamination.
  • Dispose of removed sutures in the appropriate biohazard container.
  • Observe the incision continuously throughout removal.

Goal

Only the clean portion of the suture should pass through the patient's skin during removal to reduce the risk of introducing bacteria into the wound.

Staple Removal Technique

  • Verify wound healing prior to removal.
  • Position the staple remover beneath the staple.
  • Compress the remover completely before lifting.
  • Remove staples one at a time.
  • Monitor for wound separation throughout the procedure.
  • Stop immediately if wound edges begin separating.
  • Notify the provider if concerns arise.

Post-Removal Wound Assessment

Immediately after removal, inspect the wound to confirm continued healing and identify any complications requiring provider evaluation.

  • Wound edges remain approximated.
  • No active bleeding.
  • No excessive redness or swelling.
  • No purulent drainage.
  • No wound dehiscence.
  • Patient tolerates the procedure well.

Immediately Notify the Provider If:

  • Wound separates after removal.
  • Active bleeding cannot be controlled.
  • Evidence of infection is present.
  • Deep tissue becomes visible.
  • The patient experiences severe pain.
  • There is uncertainty regarding wound stability.

Steri-Strip® Application

When ordered by the provider or clinically appropriate, Steri-Strips® may be applied after removal to provide additional wound support.

  • Ensure the surrounding skin is clean and dry.
  • Apply strips perpendicular to the incision.
  • Avoid excessive tension.
  • Leave small spaces between strips.
  • Do not apply ointment over Steri-Strips® unless directed by the provider.
  • Allow Steri-Strips® to fall off naturally unless otherwise instructed.

Patient Education

Before discharge, provide the patient with clear wound-care instructions and reinforce signs that require medical attention.

  • Keep the area clean and dry as instructed.
  • Avoid pulling or picking at Steri-Strips®.
  • Monitor for redness, swelling, drainage, or fever.
  • Avoid activities that place excessive tension on the incision until cleared by the provider.
  • Contact the clinic promptly with any concerns regarding wound healing.
  • Seek emergency care for severe bleeding or wound separation.

Documentation Requirements

  • Date and time of removal.
  • Provider authorization.
  • Location of the wound.
  • Number of sutures or staples removed when appropriate.
  • Assessment of wound appearance.
  • Presence or absence of drainage or infection.
  • Application of Steri-Strips® or dressing.
  • Patient tolerance of the procedure.
  • Patient education provided.
  • Provider notification when applicable.
Documentation should clearly describe the condition of the wound both before and after removal, along with any provider communication or additional interventions.

Quality Assurance

Medical Assistant

  • Verify provider authorization.
  • Follow clean technique.
  • Monitor for complications.
  • Provide patient education.
  • Complete documentation.

Provider

  • Determine removal timing.
  • Evaluate delayed healing.
  • Assess complications.
  • Provide additional treatment when indicated.

Leadership

  • Ensure staff competency.
  • Maintain removal supplies.
  • Audit documentation.
  • Support quality improvement initiatives.

Suture & Staple Removal Checklist

✅ Verify patient using two identifiers
✅ Confirm provider authorization
✅ Gather appropriate supplies
✅ Assess wound healing
✅ Perform hand hygiene and don PPE
✅ Remove sutures or staples using proper technique
✅ Monitor for wound separation
✅ Apply Steri-Strips® or dressing when indicated
✅ Educate the patient on wound care
✅ Document the procedure completely
✅ Notify the provider of any complications

Sawubona Standard

Suture and staple removal is more than completing a procedure—it is the final assessment of a patient's healing journey. Every removal should be performed with precision, careful observation, and compassionate communication to ensure the wound continues to heal safely and the patient leaves feeling confident in their recovery.
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