Suture Removal Nursing Skill | How to Remove Surgical Sutures (Stitches)

Summary

This video tutorial explains how to safely remove simple interrupted sutures, commonly used to close wounds after surgery or injury. It covers essential steps like verifying physician orders, gathering supplies, and cleaning the suture line. The nurse demonstrates using sterile gloves and antiseptic techniques to prevent infection. Viewers learn to remove every other suture first to minimize the risk of the wound reopening, and to apply steri-strips for support. The video emphasizes proper documentation, assessing the wound for infection, and educating the patient on aftercare and signs of complications.

Takeaways

• 🧵 Surgical sutures, also known as stitches, are used to close wounds from injuries or surgeries, and there are various types, including simple interrupted sutures, which are the focus of this demonstration.
• ✂️ Simple interrupted sutures involve individual stitches, and this method is contrasted with other patterns such as continuous sutures, vertical and horizontal mattress sutures, and interrupted cruciate sutures.
• ⏳ Sutures can either be dissolvable or require manual removal, with the time frame for removal ranging from 5 days to 2 weeks, depending on the location and depth of the wound.
• 📝 Nurses must have a physician's order before removing sutures and should explain the procedure to the patient, obtaining verbal consent. Pain during removal is usually minimal, though patients may feel a pulling sensation.
• 🧼 Prior to suture removal, the wound site should be assessed for signs of infection, such as redness, warmth, drainage, or weakness in the wound's appearance. Any concerns should be reported to the physician.
• 🧤 Depending on hospital protocol, sterile or clean gloves may be used for suture removal. The demonstration uses sterile gloves for infection prevention.
• ✂️ When removing sutures, always cut the thread closest to the skin to avoid dragging external bacteria into the wound, which can cause infection.
• 📏 Remove every other suture first to prevent the wound from opening prematurely. Steri-strips are then applied to reinforce the wound before removing the remaining sutures.
• 🧪 Clean the wound area with antiseptic before and after suture removal, and dispose of the sutures in a biohazard container, counting them to ensure all have been removed.
• 💡 After suture removal, educate the patient on caring for the wound, signs of infection, and allowing steri-strips to fall off naturally within 10 days.

Q & A

What are sutures and when are they used?

Sutures, also known as stitches, are used to close a wound that could have been sustained through an injury or surgical procedure. They are essential for promoting healing by keeping the edges of the wound together.

What types of sutures are mentioned in the video?

The video mentions several types of sutures: simple interrupted sutures, simple continuous sutures, vertical mattress sutures, horizontal mattress sutures, continuous blanket (or forward interlocking) sutures, and interrupted cruciate (cross-shaped) sutures.

Do all sutures need to be removed?

No, not all sutures need to be removed. Some sutures are made from dissolvable materials that naturally dissolve within the body, while others must be manually removed, which is the focus of this video.

What factors determine how long sutures remain in place?

The location of the suture and the depth of the wound determine how long sutures stay in place. They can remain for as little as 5 days or up to 2 weeks depending on these factors.

What steps should be taken before removing sutures?

Before removing sutures, verify the physician's order, explain the procedure to the patient, obtain their consent, and assess the wound for infection or other complications. It’s important to check for signs like redness, warmth, hard areas, drainage, or a weak-looking suture line.

What supplies are needed to remove sutures?

Supplies needed include a dressing change tray, sterile or clean gloves, a suture removal kit (tweezers, scissors, gauze), antiseptic, and steri-strips for reinforcing the wound after suture removal.

Why is it important to cut the suture on the side closest to the skin?

Cutting the suture on the side closest to the skin helps prevent introducing germs into the wound. The part of the thread exposed to the outside environment may carry bacteria, and pulling that part through the wound can cause infection.

What is wound dehiscence, and how can it be prevented during suture removal?

Wound dehiscence is the premature opening of a wound after sutures are removed. To prevent this, steri-strips are applied to the site where the suture was removed to reinforce the wound and prevent it from opening.

What should be done if the wound begins to open during suture removal?

If the wound begins to open during suture removal, stop immediately, cover the area with sterile gauze, and notify the physician. Avoid removing any more sutures until further instructions are provided.

What aftercare is provided once sutures are removed?

Aftercare includes applying antiseptic, placing steri-strips to reinforce the wound, educating the patient about signs of infection, advising them to let the steri-strips fall off naturally, and potentially applying a dressing if the wound is in a friction-prone area.