How long do surgical staples typically stay in place before removal?

Timing of Surgical Staple Removal

Surgical staples should typically be removed after 10-14 days post-surgery, once the wound shows evidence of healing with no significant swelling, erythema, or drainage. 1

Factors Affecting Staple Removal Timing

• Timing of staple removal varies based on the anatomical location of the wound 1, 2:

  • Scalp wounds: 7-10 days 2
  • Extremity wounds: 10-14 days 1
  • Abdominal/trunk wounds: 10-14 days 3

• Patient-specific factors that may require longer staple retention:

  • Diabetes or other conditions affecting wound healing 1
  • Immunosuppression 3
  • Wound location in high-tension areas 4

Wound Assessment Before Staple Removal

• Before removing staples, assess for 1:
  • Evidence of proper wound healing
  • Absence of significant swelling or erythema
  • No drainage or purulence
  • No signs of infection or wound complications

Risks of Improper Timing

• Removing staples too early (before 7 days) increases risk of wound dehiscence 2

  • A study of cesarean deliveries showed increased wound separation when staples were removed at 4 days compared to later removal 3
  • However, a randomized controlled trial found no significant difference in wound healing between staple removal at postoperative day 4 versus day 8 after cesarean delivery 5

• Leaving staples in place too long may lead to 2:

  • Tissue reaction
  • Excessive scarring
  • "Railroad track" marks

Procedure for Staple Removal

• Use a sterile staple remover tool to avoid wound contamination 1
• Remove staples in a sequential manner, working from one end of the incision to the other 1
• Apply sterile adhesive strips across the wound if needed for additional support after staple removal 1

Post-Removal Care

• Keep the area clean and dry 1
• Monitor for signs of infection (increased pain, redness, warmth, swelling, or drainage) 1
• Avoid excessive strain on the wound site during the initial healing phase 1
• For patients on biologic therapy for rheumatic conditions, ensure staples are completely removed before restarting medication 3

Special Considerations

• For patients undergoing lower extremity bypass surgery, suture closure may be preferable to staples as it has been associated with lower rates of surgical site infections (3.46% vs 2.06%) 6
• For foot and ankle surgeries, staples have shown comparable outcomes to nylon sutures with potentially less pain at removal 7
• In emergency situations where rapid staple removal is needed, an artery forceps can be used if a standard staple remover is not immediately available 8