What are the guidelines for removing staples from the head?

Guidelines for Staple Removal from the Head

Staples should be removed from the head 7-10 days after placement using proper infection control procedures, including sterile gloves and appropriate instruments to minimize patient discomfort and risk of infection.

Preparation for Staple Removal

Infection Control Measures

• Perform hand hygiene with either antimicrobial or non-antimicrobial soap and water when hands are visibly soiled 1
• If hands are not visibly soiled, an alcohol-based hand rub can be used 1
• Wear a new pair of medical gloves for each patient and remove them promptly after use 1
• Keep fingernails short with smooth, filed edges to allow thorough cleaning and prevent glove tears 1
• Do not wear hand or nail jewelry that may compromise glove integrity 1

Required Equipment

• Staple remover (dedicated instrument)
• Clean gloves
• Antiseptic solution
• Gauze
• Adhesive strips (optional for wound support after staple removal)

Staple Removal Procedure

Timing of Removal

• Standard timing for scalp staple removal is 7-10 days post-procedure
• Consider longer duration (10-14 days) for:
  • Wounds under tension
  • Patients with conditions that may delay healing (diabetes, steroid use, malnutrition)
  • Wounds in areas with significant movement

Technique

1. Explain the procedure to the patient to reduce anxiety
2. Position the patient comfortably with adequate exposure of the stapled area
3. Clean the area around staples with antiseptic solution
4. Insert the lower jaw of the staple remover under the staple
5. Squeeze the staple remover handles completely to bend the staple and lift it away from the skin
6. Dispose of staples in appropriate sharps container immediately 1
7. Apply adhesive strips if needed for additional wound support

Pain Management

• Consider topical anesthesia for pain reduction during staple removal
• Research shows that lidocaine patches applied around (not on) the surgical wound can effectively reduce pain during staple removal 2
• Ensure application time of >47 minutes for optimal pain reduction 2

Post-Removal Care

Wound Assessment

• Assess the wound for:
  • Complete healing
  • Signs of infection (redness, swelling, purulent discharge)
  • Dehiscence (wound separation)
  • Proper approximation of wound edges

Patient Instructions

• Keep the area clean and dry
• Avoid direct trauma to the newly healed wound
• Report any signs of infection (increasing pain, redness, swelling, discharge)
• Protect the area from sun exposure for several months to minimize scarring

Special Considerations

Infection Prevention

• Do not touch the wound with bare hands
• Use appropriate PPE including gloves when handling staples 1
• Dispose of used staples in a puncture-resistant sharps container immediately 1
• Clean and disinfect reusable equipment between patients 1

Advantages of Staples vs. Sutures

• Stapling is significantly faster than suturing for scalp wounds 3, 4
• Stapling is less painful during application 3
• Stapling eliminates risk of accidental needle-stick injury to healthcare providers 3
• No difference in wound infection rates between staples and sutures 3

Potential Complications

• Scarring
• Wound infection
• Wound dehiscence
• Pain during removal
• Retained staple fragments

Documentation

• Date and time of staple removal
• Number of staples removed
• Wound appearance and healing status
• Any complications encountered
• Patient education provided

By following these guidelines, healthcare providers can ensure safe and effective removal of staples from head wounds while minimizing patient discomfort and risk of complications.