Steri-Strips—How to Remove Them Safely After Surgery

After certain surgeries that require incisions, like hysterectomies, doctors will sometimes apply bandages called Steri-Strips (which are also known as butterfly closures or butterfly stitches). They are applied to hold the superficial part of an incision together during healing.

If you've recently undergone surgery, you may be told to wait until they fall off naturally, or instead, told to remove them after a certain number of days. What is the best way to remove Steri-Strips, and what can you do if the edges of your Steri-Strips are pulling free and either irritate your skin or may get caught on something? 

A little caution is in order to reduce the chance that your incision will get infected or break open. Here's what you need to know about safe Steri-Strip removal.

Steri-strips are essentially small pieces of tape, but the tape that clings to the skin better than ordinary household tape. They are usually used to close superficial rather than deep incisions. For example, absorbable sutures may be placed to close most of an incision, and then S Teri-Strips used to close only the superficial layer of the skin. This is helpful to remember if your Steri-Strips fall off too early. You may end up with some bleeding, or perhaps delayed closure of the surface of your wound, but it's not likely that you would end up with the gaping wound that some people fear.

From a medical standpoint, Steri-Strips are a wonderful invention. They can hold together small, contoured areas of the body that require an incision until the site heals. They can also reduce the scarring that traditional sutures might produce (the "ladder rung" scars). The challenging issues are that many people are uncertain about how long they should be left in place. And once it's time, it can be a struggle to remove them.

Let's look at the steps to take to safely remove Steri-Strips, some of the problems you may encounter, and what you can do if you are unable to remove them.

Always follow your doctor's orders—even if the Steri-Strips are itchy or irritating. Removing butterfly stitches too soon could cause your incision site to reopen. Plus, you may introduce harmful bacteria, which can cause an infection. If your doctor didn't advise you to take them off after a certain amount of time, call the office and ask if and when you should. 

We've all heard that the best way to remove a band-aid is with a speedy, yanking motion (within limits, of course, depending on the underlying wound). But the same logic does not apply to Steri-Strips. Butterfly stitches are much more adhesive than standard band-aids, meaning they will stick to your skin to a much greater degree. If you tug at Steri-Strips forcefully, you'll probably do more harm than good, and are more likely to reopen the wound.

When you are ready to take off your Steri-Strips, wash your hands carefully, and then plan to remove them one at a time. It's important to slowly and gently peel each strip, one tiny bit at a time. While you pull the strip, use your other fingers to apply pressure to your skin on both sides of the strip. (It may be helpful to have someone do this with you.) Slowly pull the strip back horizontal to your skin (so the removed strip overlaps the remaining strip) instead of pulling vertically on the strip to reduce tension on your skin.

Remove each side of the strip up to the point of the incision, and then, as a last step, remove the strip from the area over the incision itself.

Sometimes the strips are scabbed over. If this is the case, gently try lifting the strip, but don't pull off the scab. Moistening the area (as long as your doctor says it is okay for the area to get wet) may loosen a scab so that the strip can be removed, but avoid soaking the area due to the risk of infection. If removing the strip threatens to pull off the scab, it's best to wait.

Most of the time it's an option to simply wait until Steri-Strips fall off on their own. In fact, many surgeons will recommend this. Showering and the natural oils of your skin will allow the strips to peel on their own in time—usually in about ten days.

Your surgeon may have recommended removing your Steri-Strips after a certain number of days, such as 7 days. Keep in mind that this is usually only a guideline and does not mean the strips must be removed on this day. Everyone is different and every incision heals somewhat differently. A guideline of 7 days might mean that one person's Steri-Strips will fall off spontaneously after 6 days, but another will find it difficult to remove them for 9 days. If you have any doubts at all, call your surgeon. You may wish to trim Steri-Strips which have partly fallen off, as noted below.

As time passes, Steri-Strips lose their adhesiveness and begin to curl. When this occurs, you can carefully trim the edges with a small (and clean) scissors. 

If you are unable to remove your Steri-Strips and they don't fall off on their own, your doctor can always remove them at your next appointment. Most of the time, people will have a post-operative appointment around the time that the Steri-Strips should have fallen off. Some surgeons apply an extra adhesive (such as tincture of benzoin) to make sure that Steri-Strips stay in place. If so, your surgeon will have an adhesive remover in her office which will make them much easier to remove.

Once all of the Steri-Strips are removed, gently wash the area with soap and water and pat (don't rub) it dry. You may have patches of dried blood or dead skin that remain. It's not necessary (or a good idea) to scrub these off, and it's best to allow these areas to fall off in time on their own. Follow the directions your doctor recommended, whether leaving the area open to air (most common) or applying a dressing. Make sure to protect the area until it has fully healed, avoiding contact with lotions or clothing which could be irritating. Continue to watch for any signs of infection.

You should call your doctor if you have any concerns about your incision. If your Steri-Strips come off and your incision opens, it's best to see your doctor right away. Reclosing an opened incision can be a challenge, and is most effective if it occurs shortly after the incision separates. (If it is longer, the wound often has to heal by what's called "secondary intention," or by leaving the incision open and allowing it to fill in over time).

If you have any signs of infection, such as redness, drainage, swelling, or a fever, contact your doctor.

Steri-strips often fall off after a period of time, but your surgeon may have told you that you could remove them yourself after a set period of time. If you choose to do this, proceed carefully, not like you would remove a band-aid. If you are having difficulty despite the steps outlined above, it's almost always OK to wait a few days or until you see your surgeon.