Transcript H.C.A. TRAINING Suture and Clip Removal

H.C.A. TRAINING
Suture and Clip Removal
Sally Panto
AUGUST 2006
AIM
• Identify Types of Wound Closure
• Identify Correct Equipment to remove
• Demonstrate knowledge disposal of Equipment
• Identify Signs of Wound Infection
• Identify signs Wound healing
OBJECTIVES
• To demonstrate care of patient before , during and
following procedure
• Demonstrates knowledge of required responsibility in
ensuring effective documentation
• Knowledge of infection control to protect patient, self and
others during procedure
• To ensure group is aware of the difference between
items designed for single use and single patient only
• Awareness of pain control methods to minimise
discomfort
OBJECTIVES
• Demonstrate awareness correct time to
remove wound closures
• Knowledge of correct techniques for
removal of wound closure
• Recognition of complications that may
occur
• To provide practical session to allow
hands on opportunity to familiarise with
Equipment and to remove closures
Wound Closure
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Holistic Approach
Primary wound healing
Sutures –absorbable and others
Staples (based on surgeon preference)
Clips
Steristrips
Dehiscence
Equipment
• Clip removers
• Tagging and Disposal
• Stitch cutters
• Safe disposal
Wound Infection
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Identifying Infection
Signs and Symptoms
Odour
Pain
Change in appearance
Increased exudate
Pus
Reddness and or inflammation
WOUND HEALING
• What is “normal”
• What is “ abnormal”
• When to remove skin closure
• Appropriate dressing
• Reporting to nurse in Charge
PATIENT CARE
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Information to give to patient or their carer
Explaination
Reassurance
Exercise
Diet
Bathing
Driving
General well being
Diet
Contact numbers
Documentation
• Appropriate documentation – record
procedure and outcome
• Out of hours service
• Feedback to team
• Referral of patient ie practice nurse
REMOVAL OF SUTURES
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Prepare patient
Prepare environment
Prepare equipment
Prepare self
Cut stitch as close to skin as possible
Discuss reasons
Dispose of equipment- All stitch cutters should be
disposed of into sin bins at time of use
• Assess whether dressing required
• Documentation
• Skin care
REMOVAL OF CLIPS
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Prepare patient
Prepare environment
Prepare equipment
Prepare self
Disposable or reusable clip remover
Slide into position accurately
Allow patient time to recover between clips
Dispose of clip remover –
• Discuss when appropriate to use
steristrips
• Dehiscence
• Skin Care
• Documentation
WHEN TO REMOVE CLIPS AND
SUTURES
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Scalp and face
Upper limb
Lower Limb
Trunk (abdomen)
Clips usually
3-4 days
7 days
7-10 days
10-14 days
7-10 days
• If in doubt contact nurse in charge