How to remove staples and use steri strips

Nurses General Nursing

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Hey yall....still a newbie on the surgery floor...I made a HUGE mistake yesterday and have been crying all day about it. I was to remove staples from and abdominal incision that was ota. I wiped the area with the benzo sticks, started to remove the staples and then when I go to just about the last 6, the patients incision started to split open. OMG!!!! I thought I was to put the strips on last, but was informed by the doctor that I really messed up and wouldnt give me the opportunity to ask how I was supposed to do it. I didnt learn this in school, and the only one I watched that staples were ever taken out of had maybe one or two sterstrips applied in areas that werent so secure looking. Can anyone help me out? I am so mortified, I hope that I havent prolonged this patients healing process..:cry:

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Specializes in ICU/Critical Care.

All I can say is, next time you don't know how to do something, ask someone else to show you.

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Well I thought I was going on the previous one that I had witnessed. But I do make it a point to ask all the time on things. I guess I just felt that this would be the same process.....Boy, was I wrong...feel really bad.

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Specializes in ICU/Critical Care.

So did the doc have to resuture the incision?

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Specializes in Peri-op/Sub-Acute ANP.

Michigan is correct, but I have to wonder whether it would have made any difference when you put steri strips on this incision. If you had barely removed the staples before the thing started to split open I doubt that steri strips would have prevented this happening once the patient started to ambulate. It makes me think that perhaps there was an infection in their to begin with that prevented the wound to heal appropriately (which would make it almost certainly a break in sterile technique during the surgery which would make this HIS fault). Difficult to evaluate without seeing the wound, but it doesn't sound right to me from the details you are giving. How superficially/deep did this wound come apart? Did it look like there was some sub q infection going on?

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No...he called and yelled at the charge nurse that we need to be taught the proper way....The lead nurses and I went back and they pulled the skin together ( about a 3cm split) and then used the steri strips to keep the area secure. I hung in and out of her room to watch her to make sure that no additional splitting or drainage started....but I would love to know what the best or right technique is...dont go back to work for a couple of days and could really use the info....thanks

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we saw some subcutaneous tissue...no infection...but again what is the proper way to doing it? I lost most of my nursing books during Katrina and the ones I have now dont address it...

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Normally I take out every other one. I mostly take them out of hip surgeries. Had the surgeon even looked at the wound before the order was given?

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Okay so you take out every other one and then what do you do? If all staples need to be taken out and they wanted the strips to be used?

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Well, if it were me in my workplace I'd put a steri strip in the place of the removed staple. But really I'm surprised that the charge nurse you were with didn't tell you what she would do. Doesn't sound like you're getting a lot of help. Please ask someone when you go into work next about this.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

A mistake is a great learning opportunity. The fact that you feel bad about it shows that you really care and that you are trying to be the best nurse that you can be.

Normally with staple removal you remove every other one and apply steri-strips after removing the staple. The steri-strips are very strong and do work quite well at holding incisions together.

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Specializes in Med/Surg.

For me it depends on how the wound looks. I HAVE in the past taken them all out and then stripped it. If it looks well healed and they are at least a week out (some patients stay in a long time, depending on what they had done), I am ok with this. Otherwise, I take out every other, strip it, then do the other ones and strip those spots.

I don't think, IMO, this is your fault, though. The steri strips help, but if the incision split open that readily, it doesn't seem that the clips should've been ordered to come out yet?

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