Question: When sutures are removed from surgical wounds healing by primary intention, how does it affect the healing status of the wound? Answer: For the purposes of scoring M1342 -- Status of the Most Problematic (Observable) Surgical Wound, openings in the skin, adjacent to the incision line, caused by the removal of a staple or suture, are not to be considered part of the surgical wound when determining the status of the surgical wound, the Centers for Medicare & Medicaid Services responded in the January 2011 Quarterly CMS OCCB Q&As. The status of these sites would be included in the comprehensive assessment clinical documentation. Follow the Wound Ostomy and Continence Nurses Society (WOCN) Guidance on OASIS-C Integumentary Items and other relevant current CMS Q&As when determining the healing status of the incision. Select "not healing" only if the wound -- excluding the status of the staple/suture site(s) -- meets the WOCN descriptors. See the Tool below for a handy reference. You can read the WOCN descriptors at www.wocn.org/pdfs/GuidanceOASIS-C.pdf.