Thousands of surgical patients sewn back up with 'retained surgical items' left inside them

Tuesday, October 02, 2012 by: J. D. Heyes
Tags: surgery, errors, gauze

(NaturalNews) The incidence of surgeons making the mistake of leaving surgical items in patients' bodies is growing, with thousands of cases a year being reported across the United States, The New York Times has reported.

The "retained surgical items," as they are called in the medical world, are items left in a patient's body following surgery, with the vast majority of them being gauze sponges that surgeons and surgery staff use to soak up blood. "During a long operation, doctors may stuff dozens of them inside a patient to control bleeding," said the Times.

No two cases are alike, experts say, but the main issue is that surgical teams rely on what has been described as an old-fashioned method to avoid the very thing that is occurring.

In most operating rooms nurses and doctors both keep a manual count of sponges used in procedures. But in some cases, things get hectic and busy during surgery, which can lead to miscounts in the chaos.

Old system just doesn't cut it anymore

In recent years; however, new technology and sponge-counting methods have made it simpler to fix the problem. Nevertheless, a number of hospitals have resisted adopting the new methods, even though industry groups like the Association of Operating Room Nurses and the American College of Surgeons have appealed to hospitals to update their practice.

As a result, experts like Dr. Verna C. Gibbs, a professor of surgery at the University of California, San Francisco, say patients are at higher risk.

"In most instances, the patient is completely helpless," Gibbs, who is also the director of NoThing Left Behind, a national surgical patient safety project, told the paper. "We've anesthetized them, we take away their ability to think, to breathe, and we cut them open and operate on them. There's no patient advocate standing over them saying, 'Don't forget that sponge in them.' I consider it a great affront that we still manage to leave our tools inside of people."

In addition to gauze and bandages, all sorts of surgical instruments - including clamps, scalpels and, at times, even scissors - are left in patients by mistake (the Times says two-thirds of the items are sponges, however).

But how can this happen? It's not as unlikely as it seems, experts say, given the surgical environment.

Understand that, during many surgeries, patients are bleeding, hence the need for so much gauze to soak up the blood. The bandages, as a result, can sort of become camouflaged inside the body; a 4x4 cotton sponge, therefore, becomes rather easy to miss, especially inside large cavities.

As a result, abdominal operations are most frequently associated with these cases of retained sponges. Also, statistics show that surgeons are more likely to leave items in patients who tend to be overweight as well.

In the past, hospitals have required surgical team members - most often a nurse - to count, and then count again, a number of surgical items. That includes every sponge used in any procedure.

"But studies show that in four out of five cases in which sponges are left behind," the Times said, "the operating room team has declared all sponges accounted for."

A small price to pay - $10

Enter new technology, which is capable of tracking sponges through the use of radio-frequency tags.

A study published in the October issue of The Journal of the American College of Surgeons by researchers at the University of North Carolina at Chapel Hill examined 2,285 cases in which surgical sponges were tracked with a system called RF Assure Detection.

Each sponge contained a small radio-frequency tag the size of a grain of rice. Following the operation, a detector can alert a surgical team to the presence of sponges left behind.

"In the UNC study," the Times said, "the system helped recover 23 forgotten sponges from almost 3,000 patients over 11 months."

The technology only adds about $10 to a procedure.

"It's a small price to pay to enhance patient safety," Dr. Leo R. Brancazio told the Times. Brancazio is the medical director of labor and delivery at Duke University Hospital in North Carolina; the hospital adopted the Assure system about 18 months ago, after a sponge was left inside a patient during a Caesarean delivery.

"It's one extra step that takes 12 seconds at the end of a procedure," he said.

Sources:

http://well.blogs.nytimes.com

http://www.ncbi.nlm.nih.gov/pubmed/22770865

http://www.rfsurg.com/