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Surgical staples are used to close incisions after surgery. Staples may be a better option in some cases than stitches or sutures.
Unlike stitches, surgical staples don’t dissolve as your incision or wound heals. For this reason, they require some special care and must be removed by your doctor once the incision has healed.
Surgical staples need to stay in for a few days or up to 21 days (in some cases) before they can be removed.
How long your staples must stay in place depends largely on where they’re placed and other factors such as:
For example, after a C-section, staples used to close a low transverse (horizontal across the body) incision may be removed after three to four days. But staples used in a vertical incision may not be removable for 7 to 10 days or more.
Several indicators that your surgical staples may be ready to be removed include:
Never try to remove surgical staples yourself at home. Always have a licensed medical professional remove staples.
Your doctor will follow special procedures and use specific tools in order to safely remove surgical staples without causing complications.
The exact staple removal procedures your doctor uses will depend on:
It’s usually not painful when your doctor removes your surgical staples. You may feel a tugging or pinching sensation as each staple is removed.
When removing your surgical staples, your doctor will follow these general steps:
Some staples may stay inside your body permanently. This is often done to keep internal organ tissues connected and resistant to further damage.
Surgical staples are used to close surgical incisions or wounds that are too big or complex to close with traditional stitches. Using staples can decrease the time needed to complete surgery and can be less painful.
Staples may be simpler, stronger, and speedier to use to close large, open wounds than traditional stitches, and may be used after major surgery.
For example, staples are often used after C-sections because they help the incision heal faster while also reducing scar appearance.
After getting staples, the following steps will help keep them clean as you heal:
Some common surgical staple materials include:
Surgical staples are placed with a special stapler.
They don’t look quite the one on your desk. Surgical staplers look more like commercial-grade construction staplers with a handle and lever that your doctor pushes down to place the staple.
Surgeons use these specially designed staplers to safely, quickly, and precisely place surgical staples on a wound. The process is much faster than stitching or suturing because the staples are placed instantly.
Stapling skin is a precise procedure that involves using a specially designed medical stapler. This tool is engineered to bring tissue edges close together quickly and effectively. Here's a general step-by-step outline of how medical professionals staple skin:
Before the staples are applied, the area is cleaned and sterilized to prevent infection. This step includes removing any foreign objects or debris from the wound.
The area around the wound is often numbed using a local anesthetic to make the procedure as comfortable as possible for the patient.
The edges of the wound are then brought together using medical forceps. It's crucial to align the tissue properly to ensure optimal healing and minimize scarring.
The medical professional then places the stapler over the wound. The device is designed to precisely place the staple into the tissue when the handle is squeezed. This process is repeated along the length of the wound, generally with staples spaced a few millimeters apart.
Once the staples are in place, the area is cleaned again, and a sterile bandage is usually applied. The patient is given post-procedure care instructions to ensure proper healing and to minimize the risk of infection.
Using staples can significantly speed up the wound closure process, making it especially useful in emergency situations. The stapling process is typically less traumatic for tissues compared to traditional suturing techniques.
If you want to learn more about the devices used in these procedures, please visit Gastroscopy Biopsy Forceps and Dissolving Staples Surgical.
Surgical staples do carry some risks, including:
For more information, please visit Gastroscopy Biopsy Forceps.
Seek emergency medical attention if you notice any of the following symptoms around the area that’s been stapled:
Staples have a number of advantages over stitches for especially large or complex surgeries, injuries, or incisions. In some cases, they may even lower your chances of complications like infection.
Talk to your doctor before getting staples. Be sure to let your doctor know about any allergies you may have and if you’ve had any complications from surgical staples in the past.
Clinical Exercise: Scalp Laceration (stapling)
Scenario:
Following a bus collision several dozen injured patients are transported to shock trauma and the emergency department. Many of the injuries consist of lacerations from sharp edges of metal and glass during the collision including several with deep scalp lacerations bleeding profusely.
Diagnosis/Considerations:
You recognize that for most minor wounds suturing provides for the two primary goals, hemostasis and achievement of a functional scar that is cosmetically acceptable.
Staples are an acceptable alternative for linear lacerations through the dermis that have straight, sharp edges and are particularly well suited for scalp lacerations. The closure of scalp wounds with staples is faster than sutures with similar outcomes when compared to sutures (indistinguishable infection, healing time, and cosmetic outcomes compared to sutures). However, since meticulous skin positioning is not readily achievable with staples, injuries involving the face should be closed with sutures. Additionally, due to patient discomfort injuries to hands and feet are also typically not closed with staples.
Because staples may be placed more rapidly than sutures and eliminate the risk of needle stick injury which is elevated in the busy environment of a multiple casualty event, you decide that the patient's scalp wound is best addressed using a skin stapler.
Mechanism:
The goal is to bring the edges of the cut tissues close together to promote healing and provide sufficient security across the opening to achieve hemostasis.
Modern surgical staplers consist of disposable plastic dispensers that can deliver single staples either with a low profile head (usually for skin) or a long endoscopic head that can be articulated (to allow reaching deep structures through a small opening). For a scalp laceration a low profile head provides suitable access.
The use of a skin stapler involves light compression of the skin on each side of the laceration with forceps in order to bring the edges into continuity. Pressure slightly elevates the skin edges of the laceration for the staple to penetrate.
Treatment (perform these steps on the donor in a mock-procedure):
PREPARATION: Send a member of your team to the instrument supply tables to fetch one 35-staple skin-type disposable dispenser and one staple remover, which looks like a small white handle scissor-like instrument (please take only the supply numbers indicated to ensure sufficient supplies are available for all tables).
In a living patient, the skin on each side of the laceration would be anesthetized using topical (e.g. lidocaine-epinephrine-tetracaine [LET] gel) or an infiltrate analgesic (e.g. isotonic buffered lidocaine). In our donor we will skip this step.
1) Open the sterile stapler packet, observing the staple delivery and trigger ends of the device.
CAUTION: exercise care when handling staplers to prevent stapling parts of your hand or body.
Note, it is difficult for one person to staple an incision. Typically, one person will use forceps to control the edges of the laceration to bring them into contact (i.e. reapproximate the edges) while the second person utilizes the stapler.
In a living patient, the skin is controlled using mouse-tooth forceps (i.e. the 'toothed' end forceps style), but with the higher density of tissue in an embalmed donor you may need to use a hemostat (hemostats may damage living tissue).
2) The first person should use forceps, or a hemostat if needed, to position the edges of your prior scalp incision into continuity (i.e. pressing the edges together) applying light pressure so that the skin bulges slightly on each side of the incision.
3) The second person should then position the stapler across the incision site close to the forceps tips, such that the cut edges of the tissue are positioned against the 'gap' in the dispenser from which the staple will be delivered.
4) Squeeze smoothly and firmly on the dispenser trigger and then release.
A staple should have been expelled with one arm of the staple penetrating the tissue on each side of the incision and holding the edges together.
5) Repeat the process approximately 3-5mm along the incision.
Each person should use only 3-4 staples evenly spaced. Each stapler holds only 35 staples and everyone in the team should have the opportunity to use the instrument and be the skin control person. If the stapler runs out, there are several additional at the supply table
Scenario (addendum):
As you place the staples you realize that one of them has been incorrectly positioned and is gripping only one side of the incision. Leaving the incorrectly placed staple in place would interfere with another staple in that location and could cause a weak point that may continue to bleed. Thus, you need to remove the incorrectly placed staple and re-staple securely in that location.
Treatment (continued):
7) Identify the two sides of the staple remover teeth.
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