Surgical sponges are used to absorb fluids during surgery and are designed to be sterile. They can be left inside patients, causing complications. Techniques to prevent retention include counting sponges and tools, using radiopaque material, and adding RFID tags.
A surgical sponge is a specialized sponge or pad used in surgery. Also known as an abdominal sponge, a surgical sponge is used to absorb fluids from a surgical site. It can be used in conjunction with suction to keep a surgical site clear, by a working surgeon to control bleeding, and in a number of other applications. Like other things used in surgery, sponges are designed to be sterile; they are supplied in their sterile packaging and can be safely sterilized in an autoclave. They are generally disposable and discarded after surgery in biohzard containers that hold other single-use surgical instruments and equipment.
The surgical sponge has legendary status among people who are concerned about items that are left inside patients during surgery. In fact, the sponge has such a long history of ending up on the wrong side of stitches after surgery that there’s even a special term for a situation where a surgical sponge is left inside a patient: gossypiboma. Sponges are left behind for a variety of reasons, ranging from the small size that allows some sponges to slip into a hidden area, to surgery performed in an emergency when the surgeon and surgical team may be more worry about putting the patient through surgery than anything else.
There are several techniques that can be used to control surgical sponges to reduce the risk of them being left in the patient. The simplest is to count all the sponges and tools, sometimes with the assistance of a barcode scanner. In this case, everything is counted or scanned before surgery and counted or scanned after. This allows the surgical team to immediately identify missing instruments and sponges.
Many manufacturers incorporate a strip of radiopaque material into each sponge they produce. This means that if a sponge is left in the body, an X-ray machine can be used to identify the sponge and pinpoint its location so it can be removed. This system isn’t foolproof, however, as sometimes the stripe can be hidden behind a structure such as bone, making the sponge effectively invisible.
Another technology designed to prevent the dreaded surgical sponge retention includes adding an RFID tag to each sponge. The tag can alert the surgical team when a sponge is left inside a patient and can also be used when counting sponges and instruments after a procedure.
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