It is estimated that there are 4,000 cases of “retained surgical items” reported in the United States on an annual basis. And many think that this number is way too low. In a recent article, the New York Times analyzed the method used by surgical teams to avoid leaving surgical instruments and sponges in the patients’ body following surgery. Items left include clamps, scalpels, scissors, and suturing devices. The most common retain surgical item is a sponge. These sponges (or towels as they are sometimes referred to) are often used by surgeons to soak up blood. During longer operations, doctors may use dozens of these inside a patient to control bleeding. But keeping track of the number of sponges going in and number of sponges going out can often be difficult in a chaotic environment of the surgical suite.
Many hospitals still rely on the old-fashioned method of manually counting the number of sponges placed in the patient and the number of sponges that come out. But miscounts occur, and patients can be left with negative results ranging from very minimal to very devastating. These towel-like devices can be a major source of infection and can adhere to organs in the body. Often, the effect of the retained sponge can remain dormant in a patient for a long period of time before a devastating effect is quickly known. There are new technologies and sponge-counting methods that have been developed in recent years to help reduce the number of retained items left in patients. Unfortunately, many hospitals have been slow or even outright resistant to adopting these methods and their surgical practices.
All hospitals should be required to use the more technologically advanced counting and tracking devices in their surgical protocols. This technology includes the ability to track sponges through the use of radio-frequency tags. In a study done at the University of North Carolina at Chapel Hill, it was reported after looking at 2,285 cases using this more technologically advanced tracking system, 23 miscounted sponges were recovered from patients during an 11 month period. Using a system called RF Assure Detection, every sponge contains a tiny radio-frequency tag about the size of a grain of rice. At the conclusion of the surgery, a detector alerts the surgical team if any sponges remain inside the patient. The cost of using this system adds about $10 to the cost of the surgical procedure. Other technology includes using barcodes.
In any event, most hospitals can improve their methods to help accurately count surgical devices and should be required to do so.