1. Objective

To safely and effectively remove sutures (stitches) from a wound, ensuring minimal discomfort for the patient and promoting optimal healing without infection.

2. Scope

This SOP applies to all licensed healthcare professionals providing stitch removal services under Upashay’s doctor services. It covers routine stitch removal for non-complicated wounds and is not intended for wounds that require emergency care.

3. Required Personnel

  • Licensed doctor or registered nurse trained in wound care and stitch removal

4. Required Equipment and Supplies

  • Sterile gloves
  • Personal protective equipment (PPE): mask, face shield
  • Sterile stitch removal kit (includes stitch scissors and forceps)
  • Antiseptic solution (e.g., chlorhexidine or iodine)
  • Sterile gauze pads
  • Adhesive strips or sterile dressing (if needed)
  • Waste disposal bag (for biohazard materials)

5. Pre-Procedure Preparation

  1. Patient Assessment
    • Review the patient’s medical history, including any known allergies, wound type, and healing progress.
    • Assess the wound for redness, swelling, drainage, or signs of infection (if signs of infection are present, delay the procedure and advise medical follow-up).
    • Explain the procedure to the patient, discuss any discomfort they might feel, and obtain informed consent.
  2. Environment Preparation
    • Ensure a clean and well-lit environment to minimize infection risks.
    • Gather all necessary equipment within easy reach before starting the procedure.
    • Position the patient comfortably, with the wound site easily accessible.
  3. Hand Hygiene and PPE
    • Perform hand hygiene thoroughly and wear sterile gloves.
    • Use appropriate PPE, including a mask and face shield, to maintain a sterile environment and prevent infection.

6. Procedure Steps

  1. Clean the Wound Area
    • Clean the area around the sutures with an antiseptic solution, using sterile gauze pads. Move gently in a circular motion from the wound outward.
    • Allow the area to dry before proceeding with the stitch removal.
  2. Inspect the Sutures
    • Check each suture to ensure they are intact and the wound edges are healing properly.
    • Confirm that there is no visible inflammation or signs of infection at the suture sites.
  3. Remove the Sutures
    • Using the sterile stitch scissors and forceps, gently lift one end of the suture knot with the forceps.
    • Slide the scissors under the suture knot close to the skin surface, avoiding pulling the knot through the wound to reduce irritation.
    • Carefully cut the suture and pull it out in one smooth motion, minimizing discomfort for the patient.
    • Repeat this process for each suture, being cautious not to disrupt the healing tissue.
  4. Inspect the Wound
    • After removing all sutures, inspect the wound edges for proper healing and check for any areas that might need additional support.
    • If necessary, apply adhesive strips to support wound closure or a sterile dressing to protect the area.

7. Post-Procedure Care

  1. Apply Dressing (If Needed)
    • Apply a sterile dressing if the wound site is still delicate or if there is any residual bleeding.
    • Secure the dressing with adhesive tape if required.
  2. Patient Education
    • Instruct the patient on keeping the wound site clean and dry for the next few days.
    • Advise the patient to avoid strenuous activities that may disrupt healing.
    • Inform the patient of signs of infection, such as redness, swelling, warmth, or discharge, and to seek medical attention if these symptoms occur.
  3. Documentation
    • Document the procedure, including the number of sutures removed, wound appearance, patient response, and any follow-up instructions given.
    • Record any signs of delayed healing or infection observed during the procedure.

8. Emergency Protocols

  • If significant bleeding occurs during or after stitch removal, apply pressure with sterile gauze and assess the need for further medical care.
  • If the patient experiences unusual pain, swelling, or signs of infection, provide appropriate first aid and refer to a medical facility if needed.

9. Quality Assurance and Safety Compliance

  • Adhere to all infection control guidelines, ensuring proper sterilization of equipment and safe disposal of used materials.
  • Conduct regular training on suture removal to maintain high standards of patient care and procedural consistency.