When should staples be removed after a recent laparotomy, small bowel resection, and stapled anastomosis surgery, where the staple edges are well approximated to the abdomen, performed on May 4, 2025?

From the Guidelines

Staples from a laparotomy with small bowel resection and anastomosis should typically be removed 4 days after surgery, as evidenced by reduced wound separation in those whose staples were removed 4 days after surgery 1. Based on the surgery date of May 4, 2025, the staples should be removed on May 8, 2025. The timing allows sufficient healing of the incision while minimizing the risk of scarring that can occur with prolonged staple retention. Before removal, ensure the wound edges appear well-approximated without signs of infection (redness, drainage, increased pain, or fever). Key factors to consider before staple removal include:

• Wound edges are well-approximated to the abdomen
• No signs of infection or wound dehiscence
• Patient's overall health and healing progress The procedure is typically done in an outpatient setting by a healthcare provider using a specialized staple remover. After staple removal, Steri-Strips may be applied for additional support, and the patient should keep the incision clean and dry. If any signs of wound dehiscence (separation), infection, or unusual drainage appear before or after staple removal, the patient should contact their surgeon immediately. It is essential to monitor the patient's healing progress and adjust the staple removal timing based on individual factors, such as age, nutritional status, presence of diabetes, or use of immunosuppressive medications 1.

From the Research

Staple Removal

• The provided studies do not specify the exact time for staple removal after a laparotomy, small bowel resection, and stapled anastomosis surgeries 2, 3, 4, 5, 6.
• However, it is essential to consider the wound healing process and the type of surgery performed when determining the staple removal time.
• A study on surgical wound closure by staples or sutures suggests that the choice of closure method may affect the risk of wound infection and other outcomes 3.
• Another study provides a guide to removing surgical staples, emphasizing the importance of aseptic technique and patient care 4.

Wound Healing and Closure

• The wound healing process involves four distinct phases: haemostasis, inflammation, proliferation, and maturation 4.
• Surgical staples can enhance the natural biological process of wound healing by providing a secure and stable closure 4.
• The use of staples versus sutures for wound closure has been compared in several studies, with varying results regarding the risk of wound infection and other outcomes 3, 5, 6.

Considerations for Staple Removal

• When removing surgical staples, it is crucial to consider the individual patient's healing process and the type of surgery performed 4.
• The aseptic non-touch technique (ANTT) is recommended to prevent infections during the staple removal procedure 4.
• Effective pain management, informed consent, and maintenance of a sterile environment are also essential aspects of patient care during staple removal 4.