How many days should staples be left in the head of an otherwise healthy adult or pediatric patient with a standard traumatic laceration or surgical wound?

Scalp Staple Removal Timing

Scalp staples should be removed after 7-10 days in otherwise healthy adults and children with standard traumatic lacerations or surgical wounds. 1, 2

Standard Timing Guidelines

• The American College of Surgeons recommends scalp staple removal at 7-10 days post-placement, which is earlier than other body locations due to the excellent vascular supply of the scalp. 2

• This timing differs from other anatomical sites: abdominal/trunk and extremity wounds typically require 10-14 days for staple removal. 2

• The scalp's rich blood supply promotes faster healing and lower infection rates compared to other body regions, allowing for earlier staple removal. 3

Critical Timing Considerations

Removing staples too early (before 7 days) significantly increases the risk of wound dehiscence, particularly before adequate collagen deposition has occurred. 1, 2

• A study in cesarean deliveries demonstrated that staple removal at 4 days versus later removal resulted in increased wound separation rates. 1, 2

• Early removal compromises wound tensile strength before sufficient collagen has been deposited, especially problematic in areas under tension. 2

Leaving staples in place beyond 10-14 days may cause tissue reaction, excessive scarring, and characteristic "railroad track" marks along the wound edges. 2

Pre-Removal Wound Assessment

Before removing staples, the American College of Surgeons recommends verifying: 2

• Evidence of proper wound healing with approximated edges
• Absence of significant swelling or erythema
• No drainage or purulent discharge
• No signs of active infection

Factors That May Extend Staple Retention

Certain patient-specific factors may require keeping staples in place longer than the standard 7-10 days: 2

• Diabetes mellitus or other conditions impairing wound healing (diabetes increases infection risk 6.7-fold in traumatic lacerations) 3
• Immunosuppression from medications or underlying disease
• Wound location in high-tension areas of the scalp
• Presence of wound complications such as hematoma formation 4

Wound Care During Staple Retention Period

Keep the surgical dressing undisturbed for the first 48 hours unless significant leakage occurs, and avoid getting the wound wet during this initial period. 1

After 48 hours: 1

• Remove the initial sterile dressing
• Implement daily incision washing with chlorhexidine to reduce surgical site infections
• Gentle cleansing around (not directly on) the staple line may be performed
• Avoid using tape directly on the skin; use gauze or tubular bandages instead

Monitor for infection signs including increased pain, erythema, purulent drainage, or fever throughout the healing period. 1

Staple Removal Procedure

The American College of Surgeons recommends: 2

• Use a sterile staple remover tool to avoid wound contamination
• Remove staples in a sequential manner
• Apply sterile adhesive strips (Steri-Strips) across the wound if additional support is needed after removal

Post-Removal Care

After staple removal: 2

• Keep the area clean and dry
• Continue monitoring for signs of delayed infection
• Avoid excessive strain on the wound site during the early remodeling phase