Written by Clay Smith
Home scalp staple removal by a parent is largely successful. Parent education and loss to follow up are some challenges to this approach.
Why does this matter?
Having children return for staple removal is time consuming, causing lost wages, lost time, and missed school. It’s such a simple procedure. Could we teach parents to remove their child’s staples at home?
The poor child may still have scalp staples…
This was a prospective study of 30 children over age 4 with scalp staples whose parents were taught removal using a pocket suture pad in the PED; then they were given a staple remover, instructions, and additional demo via online video. Overall, 28/30 (93%) were successful. One family delayed and had the provider do it at a subsequent scheduled visit. One poor child was lost to follow up and may graduate college with scalp staples still in there…alas! Of the 25 out of 30 (83%) parents they were able to contact and who completed the post-removal survey, all said they preferred home removal, would feel comfortable if they had it to do again, were glad they had not missed work (and wages), and glad the children had not missed school because of the need for a return visit. Five families declined participation and indicated this would not go well at home with their child. In summary, this seems feasible. If I can figure out an easy way to teach this to parents, I would consider this as an option. The child lost to follow up is a little disturbing and illustrates a potential pitfall of this approach.
Scalp Staples Placed in a Pediatric Emergency Department: Feasibility and Benefits of Home Removal. Pediatr Emerg Care. 2022 Mar 1;38(3):e1143-e1146. doi: 10.1097/PEC.0000000000002213.