Suture Removal: Procedure (Nursing)

00:04 Hey guys, welcome to suture removal.

00:06 This is a fun skill for students to learn.

00:08 And there's a few instances that you may need this.

00:11 I for example, in my clinical practice, I work in post-op nursing.

00:16 Many times, a patient has a surgical drain, it's kept intact by a suture.

00:21 So, as a nurse in the post-op care I will remove the suture, to discontinue the drain.

00:27 So, let's take a look at some of the equipment, that you're going to need.

00:30 Luckily, we have a suture removal kit, that has your tweezers and your suture removal scissors, in it for you.

00:38 Next, you're going to have normal saline or what other cleansing agent your facility may require.

00:44 Also, sometimes we may need a little extra help closure, after we remove those sutures, so, we're going to use adhesive strips.

00:52 So, before we get started don't forget your hand hygiene and of course, provide privacy to your patient.

00:58 So, we need to explain this procedure thoroughly to your patient.

01:02 And of course, we want to raise the bed to an appropriate working position.

01:06 So, one point to know, sutures can be in several different areas in their body, it could be in someone's head, it could be a surgical drain in the back, so just know get wherever is going to be comfortable for you to work and then assist the patient to the proper position for this.

01:24 So, once we get started, we need to perform hand hygiene and put on our gloves.

01:29 Now, occasionally you may have a wound dressing, that's covering those sutures.

01:33 If that's the case, we won't remove it at this time and then assess the incision site and the patient's level of pain.

01:40 We want to take a close look at this incision site and see if it's healing well.

01:45 Now, are there signs and symptoms of infection, is it red, is it warm, is there pus.

01:50 We need to assess each of these and report and see if there's anything abnormal here.

01:55 Now, if there was a dressing and we removed this, because it's a dirty dressing our gloves are soiled and we want to remove those, perform hand hygiene again and put on new gloves.

02:07 Once we have our new gloves on, we can go ahead and open that suture removal kit.

02:12 Then we want to go ahead and cleanse the incision site with saline from inner to outer aspect of the wound.

02:19 Once we've cleansed this, we want to take our tweezers or whatever we have in our kit to grasp and cut the stitch.

02:27 Now, here's an important point.

02:29 Notice if you take a look at this image, we are grabbing the knot and we are making sure to keep the knot intact.

02:37 We do not want to cut the knot.

02:39 So, I repeat, we do not want to cut the knot.

02:42 Because that will make it difficult to remove the whole suture.

02:47 So, how we do this.

02:48 We are going to remove the suture by lifting and gently pulling the stitch, so, the knot does not pass through the skin.

02:55 Now, you're going to repeat this until all the sutures are removed, unless ordered otherwise.

03:00 We want to gently cleanse the incision site with our cleansing agent and sometimes there's going to be gaps in the incision and we want to apply adhesive strips here.

03:10 Then we're going to apply a dressing, if necessary, or if ordered by the physician.