Oxidized Regenerated Cellulose Mimicking a Retained Laparotomy Sponge

Area of Science:

• Surgical Innovation
• Radiology
• Materials Science

Background:

• Oxidized regenerated cellulose (ORC) is a widely used absorbable hemostatic agent in gynecologic surgery.
• This case involves a patient undergoing posterior pelvic exenteration for a malignant pelvic mass, a complex procedure often requiring extensive surgical materials.

Observation:

• An intraoperative radiograph, performed due to an incomplete laparotomy pad count, revealed a suspicious radiolucency in the patient's pelvis.
• Surgical reexploration was necessitated to rule out retained surgical material.
• During reexploration, oxidized regenerated cellulose (ORC) was identified at the location of the radiolucency.

Findings:

• Radiographs of the removed ORC confirmed its radiolucent appearance, mimicking a retained surgical sponge.
• The ORC material itself, not a surgical sponge, was the cause of the radiographic finding.

Implications:

• This case demonstrates that oxidized regenerated cellulose can be misidentified as a retained surgical sponge on intraoperative radiographs.
• Awareness of this radiographic characteristic of ORC is crucial to prevent misdiagnosis and unnecessary surgical interventions.
• Disseminating this knowledge can improve perioperative safety and reduce patient anxiety associated with potential retained surgical items.