From the Guidelines
Staples from cardiovascular (CV) surgery are typically removed 7-14 days after the procedure, depending on how well the incision is healing. Here's what you need to know:
Recommendation
Wait at least 7 days before removing staples, but follow your surgeon's specific instructions.
Additional details
- Your surgeon will assess the incision at follow-up appointments
- Removal may be delayed if there are signs of poor healing or infection
- A healthcare professional should remove the staples, not the patient
- After removal, Steri-Strips may be applied to provide additional support
Reasoning
Staples are left in place long enough to allow the incision edges to form a strong bond. This timeframe balances the need for wound closure with the risk of scarring from leaving staples in too long. The exact timing depends on individual factors like age, overall health, and the specific surgical procedure performed. According to a study published in 2017 1, wound closure is typically reached by 14 days, and biologic therapy can be restarted once the wound shows evidence of healing, all sutures/staples are out, and there is no clinical evidence of non-surgical site infections. However, another study published in 2018 1 suggests that staples were removed 4 days after surgery in some cases, but this may not be applicable to CV surgery. Therefore, the recommendation is to wait at least 7 days before removing staples, but follow your surgeon's specific instructions.
From the Research
Removal of Staples after Cardiovascular Surgery
- There is limited research directly addressing the removal of staples after cardiovascular (CV) surgery.
- However, studies on staple removal after other types of surgery can provide some insight:
- A study on cesarean delivery found that staples can be removed as early as postoperative day 3-4 for low transverse incisions and days 7-10 for vertical incisions 2.
- Another study on cesarean delivery compared early (postoperative day 4) and late (postoperative day 8) staple removal and found no significant differences in scar healing and cosmetic outcome 3.
- For infrainguinal bypass surgery, a study found no significant differences in wound complications between continuous polyamide sutures and metallic skin staples, but skin closing time was significantly shorter with staples 4.
- A study comparing staples and sutures for chest and leg wounds after cardiovascular surgery found that sutured skin closure may be superior to stapled closure in terms of reducing wound infections and improving cosmesis 5.
- It is essential to note that the optimal time for staple removal may vary depending on the individual patient, the type of surgery, and the surgeon's preference.
- More research is needed to determine the best practice for staple removal after CV surgery.