No sponge left behind

September 30, 2010
A sponge left inside a patient is visible in the lower right quadrant of this X-ray image. Credit: Image provided by Christopher C. Rupp, M.D.

Using the same technology found in clothing tags used in retail store tracking systems, a study from the University of North Carolina at Chapel Hill shows that surgical sponges with implanted radio frequency (RF) tags may be an effective adjunct to manual counting and X-ray detection in preventing sponges from being left behind in patients following a surgical procedure.

UNC surgeons will report the preliminary results of the study on Tuesday, Oct. 5 during a poster session at the 2010 Annual Clinical Congress of the American College of Surgeons in Washington, D.C.

The reported incidence of a sponge or another foreign body, such as a surgical instrument, being left behind after operations has varied widely over the years. Previously published reports have estimated ranges of one in 1,000 operations to one in 18,000.

"Our preliminary data agrees with the previously reported incidence of retained surgical sponges," said lead investigator UNC gastrointestinal surgeon Christopher C. Rupp, MD. The researchers used a radio-frequency (RF) detection device in 1,600 operations, and found a sponge in one operation in which manual counting of the sponges was correct.

Sponges used to absorb fluids and improve access to organs during surgical procedures are much different than household sponges. Surgical sponges are mostly made of cotton, and come in sizes of 12-by-12 inches or as small as 4-by-4 inches. These sponges can become difficult to see during an operation because they can mold into different shapes and take on the same color of the fluids being absorbed. Furthermore, the sponges can migrate to other areas of the operative field, and they can be difficult to feel with surgical gloves.

Surgeons use various methods to track sponges during operations. The most common is manual sponge counts by a nurse, but more sophisticated methods include the radio-frequency tagged sponges used in the UNC study, X-ray of the abdomen and bar-coded sponges. The UNC investigators did not include bar-coding systems in their study. Human error involved with manual counting and X-ray interpretation were the impetus that resulted in the studies inception, Rupp reported.

The RF-tagged system in the UNC study has the same technology found in the clothing tags used in retail store tracking systems and in microchips embedded in pets. During surgery, a nurse passes a wand over the patient's body to pick up readings from the RF tags. Newer versions have detection hardware built into the mat the patient lies on. "RF detection is not going to replace counting in the operating room, but it can be used as an adjunct because, from what we're seeing in the preliminary data, it adds a lot to the safety of the procedure," Rupp said.

"Any foreign body present long enough has a risk of causing infection," he explained, noting there are patients in whom sponges have eroded into other organs, mainly the intestines. "People can come back with chronic pain issues after an operation that also leads to detection of a retained surgical sponge," which may require being hospitalized for additional surgery.

Related Stories

Recommended for you

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.