suture removal ppt.pptx medical surgical

suture removal ppt.pptx medical surgical

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  SUTURE REMOVAL
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  INTRODUCTION Suture removal isa process of removing materials used to secure wound edges or body parts together from healed wound with out damaging the newely formed tissue. The timing of suture removal depends on the shape , size and location of the sutured incision. The sutures may be removed by the surgeons or by the surges regarding to the tropical customs. In all cases the surgeon gives the written order for the removal of the sutures.
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  PURPOSE Sutures are foreignbodies and if they are not removed they are capable of causing local inflammation.
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  PRINCIPLES  Never pullthe visible portion of the suture through underlying tissue.  Suture line is cleansed before and after suture removal.  No part of the stitch ,which is above the skin level enter and contaminate the tissue under the skin. USUAL TIMINGS 1) Scalp and free - 2 to 5 days 2) Abdominal wounds - 7 to 10 days 3) lower limbs - 10 to 14 days
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  FACTORS AFFECTING SUTUREREMOVAL 1) Types of suture 2) wound healing  Types of suture : REMOVING STAPLES To remove staples the nurse simply inserts the tips of the staple removal under each wire staples. Squeezes are centre of the staple with the tips, freeing the staples from the skin. INTERMITTENT SUTURE The surgeon ties each individual suture made in the skin. CONTINUOUS SUTURE It is series of the sutures with only two knots. RETENSIONS OF SUTURE They are placed deeply than the skin sutures.
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  GENERAL INSTRUCTIONS  Confirmthe doctor’s order for the removal of the sutures.  The suture removal is done in conjunction with the dressing charge  The suture line is cleaned before and after suture removal  When removing interrupted sutures , alternate once are removed first.  Suture material left beneath the skin acts as a foreign body and inflammatory response.
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   Wound dehiscenceoccurs during the removal of sutures ,inform the surgeon immediately.  Alter removing the sutures ,even if the wound is dry ,a small dressing is applied for the a day or two to prevent infection.  If wound discharge occurs ,the patient should be instructed to conduct the surgeon.  Abdominal belts or many tailed bandages may be applied to the abdomen after removal of abdominal sutures in obese patients to prevent wound dehiscence and evisceration.
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  PRELIMINARY ASSESSMENTS Check thephysician’s order Assess the general condition of the patient Check the specific precautions any Check the consciousness of the patient and his ability to follow instructions. PREPRATION OF THE PATIENT AND ENVIRONMENT  Explain the procedure of the patient  Provide privacy if needed  Clean the area before and after the procedure
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  EQUIPMENTS 1) Waterproof thrashbag 2) Adjustable light 3) Clean gloves, if the wound is dressed 4) Sterile gloves 5) Sterile forceps 6) Normal saline solution 7) Sterile gauze pads 8) Antiseptic cleaning agent 9) Sterile curve tipped suture scissors( for removing sutures) 10)Povidone iodine sponges( protect skin and prevent the infection)
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  11) Optional adhesivebutterfly strips and compound benzoin tincture or other skin protectant( protects the skin from allergy and makes the bandage adhere longer) PROCEDURES 1) To remove the interpreted sutures, grasp the suture at the knot with a toothed forceps and pull it gently to expose the portion of the stich under the skin. 2) Cut the suture with a sharp scissor between the knot and the skin on one side, either below the knot or opposite side of the knot. Then pull the thread out of one piece.
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  3)The suture whichis already above the skin should not be drawn under the skin. After removal of sutures every suture should be examined for the completeness .The number of sutures should be countered before and after removal. 4) Mattress intercepted sutures have no threads underlying the skin . The visible part of the suture opposite the knot should be cut and the suture is removed by pulling in the direction of the knot. 5) If a continuous suture is applied ,it is cut through close at each skin orifice on one side and the cut sections are removed through the opposite side by gentle traction.
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  AFTER CARE • Afterthe removal of any suture ,the nurse should clear the area. • The nurse can also give dressing to the area to prevent infection. • Inform the patient to keep the area clean • Document the status of the wound ,after suture removal.
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  TYPES OF SUTURESNEEDLES