Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

REMOVAL OF STITCHES

Removal of stitches is an aseptic procedure performed only when the wound has adequate healing and a prescription or approved protocol allows removal. The nurse assesses wound integrity, removes sutures without dragging contaminated thread through tissue, and provides support if separation occurs.

Purpose

  • Remove sutures after adequate tissue healing
  • Reduce irritation, local infection risk, and stitch marking
  • Assess healing and provide wound-care education

Indications

  • A written order or facility protocol for suture removal
  • A closed, stable wound at the appropriate review time
  • Removal of selected sutures as directed by the surgical team

Equipment

  • Sterile suture removal kit or sterile stitch cutter and forceps
  • Sterile saline and gauze
  • Clean and sterile gloves
  • Appropriate dressing or adhesive strips
  • PPE, kidney dish, waste bag, and sharps container
  • Pain assessment tool and documentation record

Preparation

  • Check whether the wound requires staged or alternate suture removal and whether adhesive strips are available.
  • Ensure analgesia and a sterile dressing are available if the wound is tender or fragile.

Procedure steps

  • Verify the order, wound site, suture type, timing, allergies, and patient identity.
  • Explain the procedure, assess pain and anxiety, obtain consent, and provide privacy and adequate lighting.
  • Perform hand hygiene, prepare the sterile field, position the patient comfortably, and expose only the wound.
  • Put on clean gloves, remove the existing dressing if present, and assess approximation, redness, swelling, discharge, and tenderness.
  • Remove gloves, perform hand hygiene, and put on sterile gloves or use the approved aseptic technique.
  • Clean the wound from the incision outward with sterile saline and allow it to dry.
  • Using sterile forceps, lift the knot and cut the suture close to the skin on one side so the external contaminated portion does not pass through the tissue.
  • Withdraw the suture gently; remove alternate sutures first when directed, reassessing wound integrity before removing the remainder.
  • Apply adhesive strips or a sterile dressing if prescribed, support the wound, and stop if edges separate or resistance is encountered.
  • Dispose of sharps safely, perform hand hygiene, reassess the patient, give wound-care advice, and document the number removed and wound condition.

Precautions

  • Do not remove sutures without authorization or before adequate healing is confirmed.
  • Stop and seek review for dehiscence, purulent drainage, marked erythema, fever, uncontrolled pain, or significant resistance.
  • Never pull the contaminated external portion of a suture through the wound.
  • Use sharps safety and account for every removed suture.

Aftercare

  • Keep the wound clean and dry as instructed and avoid tension, friction, or soaking until healed.
  • Tell the patient to report increasing redness, swelling, discharge, fever, bleeding, or separation.

Documentation

  • Record wound assessment, suture type and number removed, patient tolerance, dressing applied, and advice given.
  • Document any retained sutures, complications, referral, or change in the plan.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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