Unintentionally retained foreign bodies after surgical procedures. Analysis of 4547 cases

Abstract

challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

Endoscopic removal of a retained surgical sponge in a young Syrian refugee after Caesarean section: a case report with discussion of cultural and political consequences

“…The incidence of retained surgical instruments varies from 1 in every 1500 elective surgeries to 1 in every 300 to 700 emergency surgeries [3, 4]. In a current study up to 43 % of surgeons reported that they had already left foreign bodies in a patient after a surgical procedure and 73 % asserted the removal of one or more foreign bodies [5]. Surgical sponges are the most common foreign body retained inadvertently during surgery because of their frequent use, their varying sizes, and their loss of initial appearance when saturated with blood [3, 4].…”

Adesão ao checklist de cirurgia segura: análise das cirurgias pediátricas

“…Estudo 13 aponta como causas da menor adesão ao momento III a exaustão dos profissionais e a ausência do cirurgião responsável. Esse momento não deixa de ser menos importante do que os outros; pelo contrário, aborda questões relevantes, como a contagem de compressas e instrumentais, pois a retenção desses objetos ainda ocorre em grande proporção 3,18 . Em pesquisa 18 realizada com 2.872 médicos, foram relatados 4.547 casos de retenção inadvertida de corpos estranhos em procedimento cirúrgicos, sendo 68% compressas grandes e pequenas, 22% gazes e 5% instrumentais cirúrgicos.…”

Incidence, root cause, and outcomes of unintentionally retained intraabdominal surgical sponges: a retrospective case series from two hospitals in Togo

“…Risk factors of gossypibomas that have been reported in the literature include emergency surgery, high body mass index, unplanned change in the type of surgery, and a complex surgical procedure [ 1 , 3 , 4 ]. As in other studies [ 15 , 16 ], we noted a higher proportion of women and gynaecological interventions.…”

“…In contrast, symptoms are subacute (transit disorder, mass, non-specific abdominal pain) when the reaction is essentially fibro-granulomatous [ 16 , 18 ]. The size of the sponge may also play a role in the clinical manifestation [ 4 ], which may explain why most of the retrieved textiles were large laparotomy sponges. Patients may also present with rarer complications such as enterocutaneous fistula and intestinal migration of the gossypiboma [ 8 , 19 , 20 ].…”

“…Gossypibomas are the most common retained surgical item (RSI); needles, forceps, and retractors may also be RSIs [ 1 , 3 ]. The highest rate of this medical error occurs in abdominal surgery [ 2 , 4 ]. Clinical consequences can be dramatic, leading to a high rate of morbidity.…”