Position patient, lower bed to safe height, and ensure patient is comfortable and free from pain. Staples are made of stainless steel wire and provide strength for wound closure. Cleaning also loosens and removes any dried blood or crusted exudate from the staples and wound bed. note: When applicable, special installation instructions are provided for an assembly at the end of the removal procedure. Instruct patient not to pull off Steri-Strips and to allow them to fall off naturally and gradually (usually takes one to three weeks). Remove remaining staples, followed by applying Steri-Strips along the incision line. Removal of staples requires aseptic considerations and a staple extractor. Instruct patient to take showers rather than bathe. Confirm physician order to remove all staples or every second staple. Instruct on the importance of not straining during defecation, and of adequate rest, fluids, nutrition, and ambulation for optional wound healing. To remove intermittent sutures, hold scissors in dominant hand and forceps in non-dominant hand. Remove dressing and inspect the wound. All wounds held together with staples require an assessment to ensure the wound is sufficiently healed to remove the staples. Staple extractor may be disposed of or sent for sterilization. Procedure performed by: ***. When removing staples, consider the length of time the staples have been in situ. Click here to visit the HP video library. When an optional unit's cover is opened to replace a staple cartridge, discard the punch waste, discard the trim waste, discard the staple waste, or clear paper or staple jams, prints may still be output if other optional units are operating normally, and are not involved in the paper or staple jam removal procedure. In addition to the procedure in SCGH guideline No 16 Wound Management: Procedure Prior to the procedure Check post op instructions for the time of staple removal MR 310 caesarean section or MR 315 operation record 5. Take care when handling the optional equipment that is attached to the machine. Place a sterile 2 x 2 gauze close to the incision site. Take care when handling the optional equipment that is attached to the machine. Removal of staples requires sterile technique and a staple extractor. Removal of staples requires aseptic considerations and a staple extractor. 7. Gather sterile staple extractors, sterile dressing tray, non-sterile gloves, normal saline, Steri-Strips, and sterile outer dressing. Note: If this is a clean procedure you simply need a clean surface for your supplies. Continue to remove every second staple to the end of the incision line. Clean incision site according to agency policy. Holding the staple extractor over the disposable bag, release handles. 13. 1. Position patient appropriately and create privacy for procedure. Securely hold staple extractor and move the staple away from the incision site. This allows wound to heal by primary intention. This provides patient with a safe, comfortable place, and attends to pain needs as required. The closed handle depresses the middle of the staple causing the two ends to bend outward and out of the top layer of skin. 15. 17. If present, remove dressing and inspect the wound. Wound dehiscence, a mechanical failure of wound healing, remains a problem and can be affected by multiple factors (Spiliotis et al., 2009). If concerns are present, question the order and seek advice from the appropriate health care provider. As you start to remove the staples, you notice that the skin edges of the incision line are separating. Ensure proper body mechanics for yourself and create a comfortable position for the patient. Squeeze the handles of the tool until fully closed lifting the staple from the skin. Cleaning also loosens and removes any dried blood or crusted exudate from the staples and wound bed. This helps the cut heal and reduces scarring. Explanation helps prevent anxiety and increases compliance with the procedure. What would be your next steps? Therefore, this clinical trial is designed to compare wound healing outcomes after cesarean following early (postoperative day #3) versus delayed (postoperative day #7 - 10) skin staple removal in the obese patient. Staples are strong, quick to insert, and simple to remove. EQUIPMENT: Suture removal kit, cleansing solution, steri-strips, and gloves. Hand hygiene reduces the risk of infection. Inform patient the procedure is not painful, but the patent may feel some pulling or pinching of the skin during staple removal. Assess incision site. Think about how you can reduce waste but still consider safety for the patient. Users outside the medical profession are welcome to use this website, but no content on the site should be interpreted as medical advice. A time out was undertaken to determine that this was the correct patient and the correct procedure for this patient. After assessing the wound, determine if the wound is sufficiently healed to have the staples removed. To remove staples, the staple remover is placed at the end of staples located in healing incision. Your patient informs you that he is feeling significant pain as you begin to remove his staples. You are about to remove your patient’s abdominal incision staples according to the physician’s orders. The SOAPnote Project website is a testing ground for clinical forms, templates, and calculators. Data source: BCIT, 2010c; Perry et al., 2014, Table 4.5 Complications of Staple Removal. Is anesthetic used during the procedure? Informed Consent: Informed consent was obtained.. Verification: I have verified the correct patient, correct procedure, correct position, correct site/side, and available equipment.. Anesthesia/Sedation: None. Confirm prescriber’s orders, and explain procedure to patient. 14. Users outside the medical profession are welcome to use this website, but no content on the site should be interpreted as medical advice. Additional risk factors for dehiscence include age over 75 years, COPD, diagnosis of cancer, use of steroids, malnutrition, anemia, sepsis, obesity, diabetes, tobacco use, and previous administration of chemotherapy or radiotherapy (Spiliotis et al., 2009). Position patient, lower bed to safe height, and ensure patient is comfortable and free from pain. Or every second staple staple removal procedure note the machine and increases compliance with the procedure layer of.! As you begin to remove the staples wound is sufficiently healed to have the and... 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