Keeping track of surgical sponges

Using the same technology found in clothing tags used in retail shop tracking systems, a study from the University of North Carolina shows that surgical sponges with implanted RF tags may be an effective adjunct to manual counting and X-ray detection in preventing sponges from being left behind in patients following surgery.

The reported incidence of a sponge or another foreign body, such as a surgical instrument, being left behind after operations has varied widely over the years. Previously published reports have estimated ranges of one in 1000 to one in 18,000 operations.

"Our preliminary data agrees with the previously reported incidence of retained surgical sponges," said lead investigator UNC gastrointestinal surgeon Christopher C Rupp. The researchers used an RF detection device in 1600 operations and found a sponge in one operation in which manual counting of the sponges was correct.

Sponges used to absorb fluids and improve access to organs during surgical procedures are much different than household sponges. Surgical sponges are mostly made of cotton and come in various sizes.

They can become difficult to see during an operation because they can mould into different shapes and take on the same colour of the fluids being absorbed. Furthermore, the sponges can migrate to other areas of the operative field, and they can be difficult to feel with surgical gloves.

The RF-tagged system has a nurse pass a wand over the patient's body to pick up readings from the RF tags. Newer versions have detection hardware built into the mat the patient lies on.

"RF detection is not going to replace counting in the operating room, 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," Rupp said.