From the Guidelines
Sterile gloves are not necessary for routine suture removal, and clean, non-sterile gloves are sufficient for this procedure in most clinical settings. The suture removal process is considered a clean rather than sterile procedure because the wound has typically already begun healing, forming a protective barrier against infection. When removing sutures, healthcare providers should wash their hands thoroughly and use clean gloves to protect both themselves and the patient from potential pathogens 1. The essential supplies needed include clean gloves, suture removal kit (containing scissors or suture removal tool and forceps), antiseptic solution for cleaning the area, and sterile gauze. However, sterile gloves may be appropriate in certain situations, such as when removing sutures from immunocompromised patients, from wounds that appear infected, or in highly sensitive areas like around the eyes. The key principle is maintaining cleanliness while avoiding the introduction of new pathogens to the healing wound site, which can typically be achieved with clean technique rather than full sterile technique.
Some key points to consider when removing sutures include:
- Washing hands thoroughly before and after the procedure 1
- Using clean gloves to protect both the healthcare provider and the patient from potential pathogens 1
- Cleaning the area with antiseptic solution before removing the sutures
- Using sterile gauze to dress the wound after suture removal
- Considering the use of sterile gloves in high-risk situations, such as with immunocompromised patients or infected wounds 1
It's also important to note that the use of gloves should be guided by a risk assessment, and that gloves should be worn as single-use items and changed between patients and between different procedures on the same patient 1. Additionally, hands should be washed or decontaminated following the removal of gloves 1.
From the Research
Suture Removal and Glove Sterility
- The necessity of sterile gloves for suture removal is a topic of debate, with various studies investigating the incidence of infection with sterile versus non-sterile gloves.
- A study published in 2015 2 compared the incidence of infection after minor surgery conducted using non-sterile clean boxed gloves with surgery conducted using sterile gloves, and found that the incidence of infection in the non-sterile gloves group was significantly non-inferior compared to the incidence in the control group.
- Another study from 2004 3 demonstrated that there is no clinically important difference in infection rates between using clean nonsterile gloves and sterile gloves during the repair of uncomplicated traumatic lacerations.
- A systematic review and meta-analysis published in 2023 4 found no evidence of additional protection against wound infections with the use of sterile gloves for wound repair in the Emergency Department compared to clean gloves.
Key Findings
- The use of non-sterile clean boxed gloves for minor skin excisions was found to be not inferior to sterile gloves in terms of wound infection 2.
- The infection rate in the sterile gloves group was 6.1% compared to 4.4% in the clean gloves group, with no statistically significant difference between the two groups 3.
- A review of the scientific basis for choice and recommendation of sterile or non-sterile gloves in minor surgical procedures in general practice found limited research data, but no clear difference in infection frequency was demonstrated 5.
Implications for Suture Removal
- The available evidence suggests that sterile gloves may not be necessary for suture removal, as non-sterile clean boxed gloves have been shown to be not inferior to sterile gloves in terms of wound infection 2, 3, 4.
- However, it is essential to note that the use of gloves must be carefully thought through, and the rationale for their use should be based on researched evidence 6.