how to remove surgery staples

Surgical staple suture removal: A simple and innovative technique

¹ Department of Orthopaedics, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
² Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
³ Department of Obstetrics and Gynaecology, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India

Date of Web Publication

10-Nov-2012

Correspondence Address:
Sukhminder J. S. Bajwa
Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-2870.103355

How to cite this article:
Singh M, Bajwa SJ, Bajwa SK. Surgical staple suture removal: A simple and innovative technique. Med J DY Patil Univ 2012;5:168-9

Sir,

Staple sutures are preferred by almost every surgeon for closure of skin incisions nowadays because of their numerous benefits. Staples have the advantage of being quicker, more economical, and causing fewer infections than stitches. Disadvantages of staples are permanent scars if used inappropriately and imperfect aligning of the wound edges, which can lead to improper healing. ^[1],[2] However, few other aspects deserve special mention with regards to their use in developing nations like India. In developing countries, because of financial constraints, they are still not widely used by the peripheral health sector and their use is limited to institutional surgeries and corporate sector. However, due to massive patient load in outpatient clinics, all the patients cannot be catered for suture removal and they have to go to these peripheral health centers and civil hospitals in their areas for suture removal.

The biggest drawback at these centers is the unavailability of the necessary equipment required for precise removal of the staple sutures. Staple suture remover is a unique instrument that is specifically designed for removal of surgical staples. It is not available everywhere and all the manufacturers are not providing staple remover along with the staples. Therefore, physicians at peripheral health centers do face difficulty in removing staple sutures without the availability of the proper staple suture remover. The discomfort to the patients during removal of staple sutures without staple remover is also high, thus mandating the use of staple remover. ^[3]

Moreover, even in the health centers where such facilities are available, sometimes, one may not be able to get access to staple remover or occasionally, the equipment may malfunction or get misplaced. The problem can be challenging during unanticipated emergencies whenever calls are received from the ward or the recovery area about the suddenly enlarging hematoma or uncontrolled bleeding from the surgical suture sites. ^[4] At this juncture, one may or may not have direct access to staple remover and has to utilize his clinical knowledge and skill to rapidly remove these sutures so as to control the source of bleeding. To counter such elective and emergency situations, we have devised an innovative intervention and technique with which these staple sutures can be removed with ease. This technique is simple and easily replicable in any type of health setting and does not require a staple remover.

To use this technique, we just require two mosquito artery forceps or even simple artery forceps for the removal of sutures. One has to put each artery forceps under both ends of the staple with pointed end of the artery facing outward as shown in [Figure 1]. After stabilization in this procedure, one has to hold them tightly and rotate those inward simultaneously. This will remove the staple without any discomfort or pain to the patient. The staples will be removed in a manner similar to the ones removed by the staple remover as is evident from the similar shapes of sutures after removal by both the techniques [Figure 2]. The minimal discomfort and the equivalent results obtained by our simple technique are easily replicable by any health worker in any type of health setting as the mechanism of removal by both these techniques is the same. The simplicity of the technique, its cost-effectiveness, easy replication, and easy availability of the equipment make it a desirable alternative to staple remover, and thus can be used in any peripheral medical setup.

Figure 1: The technique of suture removal with the help of two artery forceps being operated in tandem

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Figure 2: The remarkable structural similarity of staple suture pins removed with the help of both techniques

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References

1.	Singhal AK, Hussain A. Skin closure with automatic stapling in total hip and knee arthroplasty. JK Pract 2006;13:142-3.
2.	Khan RJ, Fick D, Yao F, Tang K, Hurworth M, Nivbrant B, et al. A comparison of three methods of wound closure following arthroplasty. A prospective, randomised controlled trial. J Bone Joint Surg Br 2006;88:238-42. [PUBMED]
3.	Chughtai T, Chen LQ, Salasidis G, Nguyen D, Tchervenkov C, Morin JF. Clips versus suture technique: Is there a difference? Can J Cardiol 2000;16:1403-7. [PUBMED]
4.	Teoh MK, Burd DA, Bucknall TE. Removal of skin staples in an emergency. Ann R Coll Surg Engl 1987;69:222-4. [PUBMED]