No surgical sponge left behind

I was observing an operation once when, near the end of the long and tense procedure, a manual count of the surgical sponges showed one was missing. The following few minutes were not fun to watch as the exasperated surgical team went searching for the wayward sponge. Leaving a sponge in a patient, which is easy to do because it soaks up blood and can be hard to see, is not uncommon although the estimates of this mishap range from 1 in 1,000 to 1 in 18,000 operations. Patients who go home with a sponge can suffer later infection and pain.

Now, however, a way to keep track of sponges -- square, cotton sheets that are typically 4-by-4 inches or 12-by-12 inches -- is under development. Researchers reported Tuesday that they can flag sponges with radio frequency tags or bar codes. In a study presented at the annual meeting of the American College of Surgeons, Dr. Christopher C. Rupp, of the University of North Carolina at Chapel Hill, reviewed 2,961 cases in which sponges with radio frequency tags were used and found the technology helped to recover 21 missing sponges.

Radio frequency tags employ the same technology found in clothing tags used in retail stores to prevent shoplifting. This does not mean that a patient being discharged from the hospital would set off an alarm when passing through the exit. Rather, during surgery, a nurse would wave a wand over the patient’s body to detect any sponges -- or the patient could lie on a special mat during surgery that would detect sponges.

“Radio frequency detection is not going to replace counting in the operating room,” said Rupp, in a news release, “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.”

-- Shari Roan / Los Angeles Times

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