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Raney clip left behind the titanium mesh after cranial surgery: Case report
Qin Ling Zhang1, Yan Su2, Seidu A Richard2,3
1Anesthesia and Surgery Center, Chengdu Shang Jin Nan Fu Branch of West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.
Rationale:
Raney clips are commonly used in neurosurgical procedures to hold the scalp in place and stop bleeding during surgery. The removal of Raney clips is often the last process during cranial surgery prior to the closure of skin incision. Thus, a Raney clip found underneath the titanium mesh resulting in fever is a very rare occurrence.
Patient Concerns:
An 18-year-old male patient underwent cranial surgery due to intracranial abscess in the frontal lobe and subsequently underwent frontal skull repair using titanium mesh during which a Raney clip was unintentional left underneath the titanium mesh resulting in fever.
Diagnosis:
A thin-slice computed tomography (CT) scan was used to identify the Raney clip.
Intervention:
A third surgery was performed to remove the Raney clip.
Outcomes:
The patient fever total resolved after the third surgery with no further neurological deficits and 2-years follow-up revealed the patient is well and go about his daily activities.
Lessons:
It is crucial to ensure that all foreign objects are removed after the surgery by counting all instruments used at and after each step during the operation, including all Raney clips. This will help prevent complications and ensure the safety as well as the well-being of the patient.
Insights
A retained Raney clip beneath a titanium mesh caused a rare post-neurosurgery fever in an 18-year-old male. Surgical removal resolved the fever and prevented long-term complications, highlighting the importance of meticulous instrument counts.
Area of Science:
- Neurosurgery
- Surgical Complications
- Medical Device Management
Background:
- Raney clips are essential hemostatic devices in neurosurgery.
- Inadvertent retention of surgical instruments like Raney clips can lead to rare but serious complications.
- Titanium mesh is utilized for cranial reconstruction following neurosurgical procedures.
