Gossypiboma:
A Preventable Surgical Complication [1]
Gossypiboma:
A Preventable Surgical Complication [1]
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A Preventable Surgical Complication [1]
Adham Hamdy | December 19, 2024
#Health_care_Innovation #Patient_Safety #Gossypiboma #Biomedical_Research
#Health_care_Innovation #Patient_Safety #Gossypiboma #Biomedical_Research
Gossypiboma, also known as Textiloma, refers to the unintentional retention of foreign materials, such as surgical gauze or sponges, inside a patient's body after surgery. This rare medical error is classified as a "never event," meaning it is entirely preventable and should not occur in clinical practice.
The symptoms of Gossypiboma may present immediately after surgery or take months or even years to develop, depending on the size and location of the retained material. These symptoms can include localized infections, abscess formation, and even intestinal obstruction.
To mitigate the risk of Gossypiboma, healthcare systems have introduced barcoding technology, a modern tool designed to enhance patient safety and reduce human error. This method relies on unique codes that can be scanned to enable real-time tracking and identification.
Barcoding Technology in Surgical Safety
Barcoding systems are increasingly utilized in healthcare for tasks such as tracking surgical instruments, managing medications, documenting patient records, and preventing the retention of surgical materials. By automating documentation processes, barcoding minimizes reliance on manual counting, thereby reducing the risk of errors.
In practice, barcoding surgical sponges involves embedding a spatial Data Matrix symbology tag into the sponge. The tagged sponges are scanned in the sterile field using a handheld barcode reader before and after surgery. This approach has been shown to significantly improve the detection of miscounted sponges compared to conventional counting methods.
Benefits and Limitations
While barcoding technology has proven effective, it is not without challenges. A study comparing barcoded sponges to traditional counting methods found that barcoding identified considerably more counting discrepancies (32 vs. 13 differences, P = 0.007) and misplaced sponges (21 vs. 12 sponges, P = 0.17). However, the system also increased the time required for sponge counts (5.3 vs. 2.4 minutes, P < 0.0001) and introduced technical difficulties (2.04 issues per 1,000 sponges).
The study noted limitations, including a small sample size and its focus on general surgeries rather than higher-risk emergency procedures. Despite these drawbacks, barcoding represents a significant advancement in reducing surgical errors and enhancing patient safety.
Conclusion
Gossypiboma is a rare but serious complication that underscores the importance of rigorous surgical safety protocols. Barcoding technology offers a promising solution to prevent these errors, although further research and refinements are needed to optimize its use in diverse surgical settings.
References
C. C. Greenberg et al., "Bar-coding surgical sponges to improve safety: a randomized controlled trial," Annals of Surgery, vol. 247, no. 4, pp. 612–616, 2008.
A. A. Gawande et al., "Risk Factors for Retained Instruments and Sponges After Surgery," Obstetrics & Gynecology Survey, vol. 58, no. 4, pp. 250–251, 2003.
K. E. Bani-Hani et al., "Retained surgical sponges (gossypiboma)," Asian Journal of Surgery, vol. 28, no. 2, pp. 109–115, 2005.
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