staple removal postop day#2 on knee replacement pt?

Nurses General Nursing

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^^topic^^. I just got back from nightshift and I am kinda freaking out that I removed the staples on one of my pt's surgical site (total knee replacement) on postop day #2. Generally it is 10-14 days for staple removal, but the MD specifically wrote to remove staples on postop day #2. I checked with my charge nurse and she said to go ahead and remove the staples, which I did. The incision site was well-approximated and intact after removal of the staples. Is it common to remove staples from a surgical 2 days after surgery? Did I do the right thing? Am I going to get in trouble?

Specializes in Geriatrics, Transplant, Education.

If you had a question about the order, why not clarify with the MD?

I would have checked with the MD as well.

Specializes in Management, Emergency, Psych, Med Surg.

If you had an order to remove them, then remove them. If you were given a verbal or phone order, make sure you write it. It appears that staples were just an adjunct to the primary wound closure.

Specializes in Post-surgical nursing.

I would have questioned the order with the MD personally, but that's just knowing my own ortho surgeon's typical preferences for staple removal. Usually on our ortho/neuro/general surgery floor, our total knees have a surgical dressing and ace wrap on until postop day #3 and then a Primipore dressing that is changed PRN until the surgeon takes the staples out during an office visit around 7 days after discharge. I suppose it depends on the surgeon though. We have 4 orthopods at my hospital and they all generally follow the same postop procedure. I would have questioned the order so at least I could understand the reasoning behind the order, if nothing else. :-)

Specializes in ICU, M/S,Nurse Supervisor, CNS.

I would have clarified with the doctor and documented the convo just to be on the safe side as I've, personally, never seen staples from any surgery removed so soon post-op. And, sometimes docs make mistakes when writing orders, ya know, coulda been distracted or something. Then again, he may have very well meant to remove the staples today. If it doesn't sound right, do a little more research. I know you said you asked your charge, but sometimes you need to go right to the source, in your case the MD.

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