Preventable Errors in the Operating Room—Part 2: Retained Foreign Objects, Sharps Injuries, and Wrong Site Surgery

Dagi, T. Forcht; Berguer, Ramón; Moore, Stephen H.; Reines, H. David

doi:10.1067/j.cpsurg.2007.04.002

Cited by 31 publications

(20 citation statements)

References 63 publications

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“…This may lead to patient undergoing inappropriate treatment, resulting in morbidity and even mortality. Therefore, prevention is always better than cure, and strict measures should be taken before, during and after the surgical procedure to ensure that no foreign body is left behind within the patient's body 5 7…”

Section: Discussionmentioning

confidence: 99%

Intrathoracic gossypiboma

Hameed¹,

Naeem²,

Azhar³

et al. 2014

Case Reports

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Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include adhesions, abscess formation and subsequent infections. Gossypiboma occurs as a result of not using radio-opaque sponges, poorly performed sponge counts, inadequate wound explorations on suspicion and misread intraoperative radiographs. Therefore, this event can be avoided if strict preventive measures are taken. Moreover, further complications can be avoided following the correct and early diagnosis of gossypiboma. Gossypiboma is an important topic as it carries great medicolegal consequences for the surgeon. We have presented three cases of intrathoracic gossipiboma following previous cardiothoracic surgeries. They presented years after their surgeries, with features varying from patient to patient, ranging from cough and fever to no sypmtoms at all. CT scan only showed a mass lesion in all cases, therefore we proceeded for CT-guided biopsy which was also found to be inconclusive. It was only after entering the thoracic cavity via video-assisted thoracoscopy/thoracotomy that the diagnosis was made and sponges were taken out successfully. All our cases recovered with no further complications.

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Section: Discussionmentioning

confidence: 99%

Intrathoracic gossypiboma

Hameed¹,

Naeem²,

Azhar³

et al. 2014

Case Reports

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“…Approximately 25% of all needlestick injuries occur in the operating room, and 59% occur among surgeons. 1,17–19 On average, surgeons report a rate of approximately 11 injuries over a 3-year time period. 20 Unfortunately, medical students and surgery residents are the most vulnerable.…”

Section: Risk Factors For Sharps Injuriesmentioning

confidence: 99%

“…19,23 Approximately 60% occur while suturing muscle and fascia, and 41% while suturing skin and other tissue. 24 Most injuries occur using curved suture needles, as these are more commonly used during procedures, but straight needles are associated with a higher overall risk of injury.…”

Section: Risk Factors For Sharps Injuriesmentioning

confidence: 99%

“…However, little data exists regarding the integration and cost of safety devices in the operating room. 19 In addition to instrument-modification strategies, double-gloving can reduce the risk of infection following inoculation due to sharps injuries by minimizing the volume of blood transferred to the skin. For example, the volume of inoculum through a single layer of latex is approximately 0.064 microL, compared with 0.011 microL through 2 layers, which is a nearly 6-fold decrease.…”

Section: Strategies For Preventionmentioning

confidence: 99%

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Sharps Injuries

Waljee

Malay

Chung

2013

Plastic and Reconstructive Surgery

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Surgeons are at risk for injury in the operating room daily. Despite the ubiquity of occupational hazards, injuries remain prevalent and expensive. Although occupational hazards can include musculoskeletal conditions, psychosocial stress, radiation exposure, and the risk of communicable diseases, sharps injuries remain the most common among surgeons in practice and the most frequent route of transmission of blood-borne pathogens. Therefore, increased attention to the health, economical, personal and social implications of these injuries is essential for appropriate management and future prevention.

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“…26 The semistructured interview study conducted to inform development of our intervention video identified dramatic resistance to using HFT among surgeons. 27 They invoked a lack of evidence supporting HFT use, and reluctance to shift their gaze from a surgical wound or a microscope, as the main reasons.…”

Section: Limitationsmentioning

confidence: 99%

Hands-Free Technique in the Operating Room: Reduction in Body Fluid Exposure and the Value of a Training Video

et al. 2009

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SYNOPSISObjectives. This study sought to determine if (1) using a hands-free technique (HFT)-whereby no two surgical team members touch the same sharp item simultaneously-$75% of the time reduced the rate of percutaneous injury, glove tear, and contamination (incidents); and (2) if a video-based intervention increased HFT use to $75%, immediately and over time.Methods. During three and four periods, in three intervention and three control hospitals, respectively, nurses recorded incidents, percentage of HFT use, and other information in 10,596 surgeries. The video was shown in intervention hospitals between Periods 1 and 2, and in control hospitals between Periods 3 and 4. HFT, considered used when $75% passes were done hands-free, was practiced in 35% of all surgeries. We applied logistic regression to (1) estimate the rate reduction for incidents in surgeries when the HFT was used and not used, while adjusting for potential risk factors, and (2) estimate HFT use of about 75% and 100%, in intervention compared with control hospitals, in Period 2 compared with Period 1, and Period 3 compared with Period 2.Results. A total of 202 incidents (49 injuries, 125 glove tears, and 28 contaminations) were reported. Adjusted for differences in surgical type, length, emergency status, blood loss, time of day, and number of personnel present for $75% of the surgery, the HFT-associated reduction in rate was 35%. An increase in use of HFT of $75% was significantly greater in intervention hospitals, during the first post-intervention period, and was sustained five months later.Conclusion. The use of HFT and the HFT video were both found to be effective.

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Preventable Errors in the Operating Room—Part 2: Retained Foreign Objects, Sharps Injuries, and Wrong Site Surgery

Cited by 31 publications

References 63 publications

Intrathoracic gossypiboma

Intrathoracic gossypiboma

Sharps Injuries

Hands-Free Technique in the Operating Room: Reduction in Body Fluid Exposure and the Value of a Training Video

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