20.11 Checklist for Staple Removal

Staples are made of stainless-steel wire and provide strength for wound closure. Staples are strong, quick to insert, and simple to remove, but may cause more scarring than sutures.

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Removal of staples is similar to the removal of sutures but requires a sterile staple extractor instead of forceps and suture scissors. Typically, every second staple is initially removed, and then the remaining staples are removed at a later time. In general, staples are removed within 7 to 14 days. See Figure 20.34 for an example of staple removal.

Checklist for Staple Removal

Please follow the checklist below to review the steps for completion of &#;Staple Removal.&#;

Steps

Disclaimer: Always review and follow agency policy regarding this specific skill.

1. Gather supplies: sterile staple extractors, sterile dressing tray, nonsterile gloves, normal saline, Steri-Strips, and sterile outer dressing.
2. Perform safety steps:
   • Perform hand hygiene.
   • Check room for transmission-based precautions.
   • Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take.
   • Confirm patient ID using two patient identifiers (e.g., name and date of birth).
   • Be organized and systematic.
   • Use appropriate listening and questioning skills.
   • Listen and attend to patient cues.
   • Ensure the patient&#;s privacy and dignity.
   • Assess ABCs.
3. Confirm the provider order and explain the procedure to patient. Explanation helps prevent anxiety and increases compliance with the procedure. Inform the patient the procedure is not painful but they may feel some pulling or pinching of the skin during staple removal.
4. Prepare the environment, position the patient, adjust the height of the bed, and turn on the lights. Ensuring proper lighting allows for good visibility to assess the wound. Ensure proper body mechanics for yourself and create a comfortable position for the patient.
5. Place a clean, dry barrier on the bedside tables and add necessary supplies.
6. Perform hand hygiene and apply nonsterile gloves.
7. Remove the dressing and inspect the wound. Visually assess the wound for uniform closure of the wound edges, absence of drainage, redness, and swelling. After assessing the wound, decide if the wound is sufficiently healed to have the staples removed. If there are concerns, discuss the status of the wound before proceeding with the health care provider. For safety purposes, count the number of staples before beginning the procedure.
8. Irrigate the wound with sterile normal saline solution to remove surface debris or exudate to reduce risk of infection from microorganisms on the wound site or surrounding skin and to help loosen and remove any dried blood or crusted exudate from the sutures and wound bed.
9. Remove gloves, perform hand hygiene, and apply nonsterile gloves.
10. Place a sterile 2&#; x 2&#; next to the wound to collect the staples.
11. Remove the staples (start with every second staple).
12. Place the lower tip of the staple extractor beneath the staple. Do not pull up while depressing the handle on the staple remover or change the angle of your wrist or hand. Close the handle, and then gently move the staple side to side to remove. The closed handle depresses the middle of the staple causing the two ends to bend outward and out of the top layer of skin.
13. When both ends of the staple are visible, move the staple extractor away from the skin and place the staple on a sterile piece of gauze by releasing the handles on the staple extractor. This avoids pulling the staple out prematurely and avoids putting pressure on the wound. It also prevents scratching the skin with the sharp staple.
14. Using the principles of no-touch technique, place Steri-Strips on the location of every removed staple along the incision line. Steri-Strips are supplied in pre-cut lengths. Cut the Steri-Strips to allow them to extend 1.5 to 2 cm on each side of the incision. Steri-Strips support wound tension across wounds and eliminate scarring. This allows wounds to heal by primary intention.
15. Remove the remaining staples as indicated, followed by applying Steri-Strips along the incision line. Count the number of removed staples and compare to the pre-count to ensure safety.
16. Apply a dry, sterile dressing on the incision site or leave it exposed to the air according to provider orders.
17. Discard the supplies according to agency policies for sharps disposal and biohazard waste:
    • The staple extractor may be disposed of or sent for sterilization according to agency policy.
18. Perform hand hygiene.
19. Complete patient teaching regarding Steri-Strips, bathing, and inspecting wound for separation. Instruct the patient to:
    • Take showers rather than bathe in a tub.
    • Avoid pulling off Steri-Strips but allow them to fall off naturally and gradually (usually takes one to three weeks).
    • Receive adequate rest, fluids, nutrition, and ambulation for optional wound healing
20. Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time.
21. Ensure safety measures when leaving the room:
    • CALL LIGHT: Within reach
    • BED: Low and locked (in lowest position and brakes on)
    • SIDE RAILS: Secured
    • TABLE: Within reach
    • ROOM: Risk-free for falls (scan room and clear any obstacles)
22. Document the procedure and assessment findings regarding the appearance of the incision. Report any concerns according to agency policy.

Whether you work in an office setting, in construction, or on personal projects at home, you should always observe the proper safety measures when working with staplers. While many people know how to deal with office staplers, several industrial staplers pose a more significant risk, in spite of preventative measures built into their designs. While injuries are unlikely, it&#;s still important to exercise caution. Keep reading to learn about several safety tips you can use when working with staplers.

When Filling Your Stapler

While reloading your stapler, you should avoid pointing the ejector slot at yourself or anyone else in your immediate area. You never know if you&#;ll accidentally fire a staple, which can pose a risk to you and the people around you.

Proper Safety Measures

Keep the ejector pointed downward to avoid harming yourself or those around you. If it does accidentally discharge a staple, then it will fall harmlessly to the ground.

When Stapling

When stapling or testing out your stapler, keep your hands and fingers clear of the ejector slot. You can cause accidental injuries if you fail to notice any hands in the way.

Proper Safety Measures

Always look where you are stapling and avoid getting distracted in the middle of a project. You don&#;t know if someone will suddenly move their hand in the way or if you&#;ll shift the stapler by accident.

When You Need To Remove Staples

When you realize that you placed a staple in the wrong place or you need to unfasten some pages, you should always use a stapler remover instead of your fingers. If you do use your fingers, you risk puncturing your skin.

Proper Safety Measures

The severity of the injury can vary, but you can avoid the incident altogether by using a stapler remover. Staple removers can pull out any type of staple with ease and you don&#;t risk injury.

What You Should Do if You Accidentally Staple Yourself

As mentioned, in many circumstances, the risk of injury from typical office staplers is relatively low. But there is still a chance that injury can occur, and with heavy-duty staplers, the risk of an incident is far greater. If you&#;ve punctured your skin, you need to know the proper protocol.

What Can Cause Staple Accidents

Before going into what to do when accidents occur, you need to know the dangers of handling staplers. Knowing this can help you avoid dangerous situations and prevent accidental injuries from happening.

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Issues With Firing

These can occur when there is a jam in the staple clip or ejector. This can result from malformed staples or a clip with loose staples. When firing is an issue, people may try to dislodge the ejector using their finger, resulting in a misfire that can puncture the skin.

Distractions

While stapling, distractions may take your attention away from your own work. Whether someone starts talking to you, you hear a loud and unexpected noise, or you simply look away, you&#;re not paying attention to the task at hand. In these cases, you might accidentally staple yourself or others.

Proper Procedures After Accidental Injury

As much as we try to avoid them, injuries happen. If you or someone else becomes hurt, there are a number of crucial steps you should take to mitigate the damage and control the situation.

When You Should Call 911

Before anything, you need to determine whether the injured person is in immediate danger and needs critical medical attention. Look for these signs:

• Excessive bleeding at the point of injury
• Bleeding that doesn&#;t stop after ten minutes of firm pressure
• A staple lodged in the chest, abdomen, or neck
• Symptoms like dizziness, vomiting, shortness of breath, or unconsciousness
• A staple stuck in the eye or throat
• Noticeable rust or corrosion on the staple

When You Should Remove the Staple

For larger staples that have longer prongs, you may want to leave it in place and seek immediate medical attention. With longer staples, you don&#;t know if it traveled deep enough to harm muscle tissue, veins, or bone. With smaller staples, you could possibly remove it and not suffer serious injury.

Stop the Bleeding

If you do remove the staple and bleeding occurs, then you must apply firm and direct pressure to the puncture point. You must do this with sterilized gauze or a clean cloth until the bleeding stops or medical emergency technicians arrive.

Clean the Wound

If the wound does not require the aid of emergency medical technicians, then you need to follow up by properly cleaning the wound. Run the puncture wound under water for several minutes and clean it with antibacterial soap. Repeat this process one more time to thoroughly clean the wound.

Protect the Wound

Once you have rinsed out the wound, apply antibiotic cream to the affected area for further protection against infection. For the final step, wrap your injury in a sterilized bandage to protect it from dirt, pathogens, and other injuries.

Treat the Pain

Before taking medication to treat your pain, you should contact your doctor for their professional recommendation. The typical solution includes taking either ibuprofen or acetaminophen.

Follow up With Your Recovery

After you have treated your wound, you need to contact a healthcare provider to ensure that there are no harmful side effects to your injury. Signs of redness, swelling, increased pain, or pus at the point of injury can indicate a possible infection and should be treated immediately. You should also ask if a tetanus shot should be administered to prevent serious infection.

Practice Safety With Staplers

Take the necessary steps, whether before injury or after, to protect yourself and others from injury and infection. Remain calm and assess the situation. Contact emergency services if the wound is serious.

Have the Safest Tools for the Job

Whether you&#;re working with a regular office stapler or you need something more heavy duty for a tougher job, ensure that you purchase the best possible equipment. This is one of the best safety tips when working with staplers. Staple Headquarters offers a wide selection of staplers, staple guns, and nail guns to aid in any project you take on. Work with reliable tools to decrease your chances of injury.

Contact us to discuss your requirements of Staple Removers. Our experienced sales team can help you identify the options that best suit your needs.