Abstract

BARIDO MURGUIA, Enriqueta et al. Retention of foreign bodies in surgery: The safety of the patient at risk. Cir. gen [online]. 2011, vol.33, n.3, pp.175-179. ISSN 1405-0099.

Objective: To provide an example of patient safety breaching and the impact on patients health and the cost of medical care secondary to retained surgical items. Setting: Hospital General de Zona 8, IMSS, second level health care. Design: Cross-sectional, retrospective, observational, descriptive study. Statistical analysis: Percentages as summary measure for qualitative variables. Material and methods: We present four cases of retained surgical items (gossybipomas) treated during 2007. We only evaluated diagnosis and procedure, as well as counting of sponges and gauzes of the initial surgery. These cases occurred before the implementation of the surgical safety checklist. Results: We detected four gossypibomas, three corresponded to gauzes left by an appendectomy, a hysterectomy and a cesarean, respectively. The fourth corresponded to a sponge secondary to hiatal repair. The gossypibomas items were removed in two cases without complications. In the third, removal produced an incidental intestinal perforation that was managed with intestinal resection and primary anastomosis. The fourth was removed but causing great morbidity and working disability for more than one year. Two patients coursed with infection of the surgical site and one had two episodes of bacteriemia. Only one of the patients had the initial surgery performed at the HGZ8. It is worthwhile mentioning that at the initial surgery, counting of gauzes and sponges was reported to be complete. The time of diagnosis ranged from 1 month to 7 years after the initial surgery. Conclusion: A gossypiboma (retained surgical item) is a preventable adverse event that causes severe morbidity in patients and increases the cost of medical care. The surgical checklist, including that of gauzes and sponges, applied pre- and post-operatively is, at this time, the gold standard to avoid this adverse event.

Keywords : Gossybipoma; retained surgical item; foreign body; textiloma; safe surgery.

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