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Natural history of the retained surgical sponge
Abstract:
Retained surgical sponge is an infrequently reported condition that may be recognized incidentally during the early postoperative period, produce serious complications, or remain dormant for years. Clinical manifestations of the retained surgical sponge are a function of bacterial contamination and of the location of the sponge within the body cavity. Few sequelae follow external extrusion but internal erosion may lead to abscess, fistulas, and intestinal obstruction. Prevention requires constant sensitivity of the surgeon to this potential threat to the safe practice of surgery. The surgeon must account for an incorrect sponge count by adequate examination of the operative field and by roentgenographic studies when the issue remains in doubt. A correct sponge count does not fully preclude a retained sponge, however, and inspection of the operative field should be routine in all patients at risk.
Insights
Retained surgical sponges are rare but can cause serious complications. Surgeons must ensure accurate sponge counts and inspect the operative field to prevent this surgical error.
Area of Science:
- Surgical safety and patient outcomes.
- Medical device management in healthcare.
Background:
- Retained surgical sponges are an infrequent surgical complication.
- Can be discovered incidentally, cause complications, or remain asymptomatic for years.
Observation:
- Clinical signs depend on sponge location and bacterial contamination.
- External extrusion has few sequelae.
- Internal erosion can cause abscess, fistulas, and intestinal obstruction.
Findings:
- Accurate sponge counts and operative field inspection are crucial for prevention.
- Roentgenographic studies aid in cases of doubt.
- A correct count does not eliminate risk; routine inspection is vital.
Implications:
- Highlights the importance of meticulous surgical practices.
- Emphasizes the need for vigilance to prevent retained surgical items.
- Underscores potential for severe patient morbidity if not addressed.