Langenbeck's Archives of Surgery

, Volume 395, Issue 8, pp 1001–1007

Retained surgical sponges: what the practicing clinician should know

  • George H. Sakorafas
  • Dimitrios Sampanis
  • Christos Lappas
  • Eva Papantoni
  • Spyros Christodoulou
  • Aikaterini Mastoraki
  • Michael Safioleas
Overview
  • 382 Downloads

Abstract

Retained surgical sponges (RSS) are an avoidable complication following surgical operations. RSS can elicit either an early exudative-type reaction or a late aseptic fibrous tissue reaction. They may remain asymptomatic for long time; when present, symptomatology varies substantially and includes septic complications (abscess formation, peritonitis) or fibrous reaction resulting in adhesion formation or fistulation into adjacent hollow organs or externally. Plain radiograph may be useful for the diagnosis; however, computed tomography is the method of choice to establish correct diagnosis preoperatively. Removal of RSS is always indicated to prevent further complications. This is usually accomplished by open surgery; rarely, endoscopic or laparoscopic removal may be successful. Prevention is of key importance to avoid not only morbidity and even mortality but also medicolegal consequences. Preventive measures include careful counting, use of sponges marked with a radiopaque marker, avoidance of use of small sponges during abdominal procedures, careful examination of the abdomen by the operating surgeon before closure, radiograph in the operating theater (either routinely or selectively), and recently, usage of barcode and radiofrequency identification technology.

Keywords

Surgery Foreign bodies Retained Sponges Instruments Complications Morbidity Fistula 

Abbreviations

RSS

Retained surgical sponges

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • George H. Sakorafas
    • 1
  • Dimitrios Sampanis
    • 1
  • Christos Lappas
    • 1
  • Eva Papantoni
    • 1
  • Spyros Christodoulou
    • 1
  • Aikaterini Mastoraki
    • 1
  • Michael Safioleas
    • 1
  1. 1.4th Department of SurgeryAthens University, Medical School, ATTIKON U. HospitalAthensGreece

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