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>Journals >Cirujano General >Year 2011, Issue 3


Baridó ME, Hernández PA, Menjivar RA, Torres RF, Miranda NG
Retention of foreign bodies in surgery. The safety of the patient at risk
Cir Gen 2011; 33 (3)

Language: Español
References: 20
Page: 175-179
PDF: 4. Kb.


Full text




ABSTRACT

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.


Key words: Gossybipoma, retained surgical item, foreign body, textiloma, safe surgery.


REFERENCIAS

  1. Medina PJ, Cote EL. Complicaciones postoperatorias. Cuerpo extraño u oblito después de una intervención quirúrgica. En: Seguridad del paciente: Una prioridad nacional. Editado por la Academia Mexicana de Cirugía. 2009: 45-57.

  2. Leap Frog Group Website: http://www.leapfroggroup.org Consultado 28 de septiembre de 2011.

  3. Gawande AA, Studdert DM, Oray EJ, Brannan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. N Engl J Med 2003; 348: 229-235.

  4. Wan W, Le T, Riskin L, Macario A. Improving safety in the operating room: A systematic literature review of retained surgical sponges. Curr Opin Anaesthesiol 2009; 22: 207-214.

  5. Kaiser CW, Friedman S, Spurling KP, Slowich T, Kaiser HA. The retained surgical sponge. Ann Surg 1999; 224: 79-84.

  6. Egorova NN, Moskowitz A, Gelijns A, Weinberg A, Curty J, Rabin-Fastman B, et al. Managing the prevention of retained surgical instruments: What is the value of counting? Ann Surg 2008; 247: 13-18.

  7. González-Ojeda A, Rodríguez-Alcantar DA, Arena-Márquez H, Sánchez Pérez-Verdia E, Chávez-Pérez R, et al. Retained foreign bodies following intra-abdominal surgery. Hepatogastroenterology 1999; 46: 808-812.

  8. Pérez GR, Rodríguez GH, Hernández BS, et al. Textiloma que semejan patología abdominal tumoral. Descripción de seis pacientes. Cir Gen 1998; 20: 263-267.

  9. Salinas LJ, Ortega RA, Senties CR. Seguridad en el paciente quirúrgico. Cuerpos extraños retenidos. Póster 262 Foro de Investigación quirúrgica y trabajos libres. XXXIII Congreso Internacional de Cirugía General 2009.

  10. Ortiz-Mendoza CM. Textiloma inguinal después de safenectomía simulador de neoplasia. Cir Cir 2010; 78: 269-271.

  11. Cárdenas GO, Rivera VA, Domínguez CL, Espinal BR. Textiloma. Comunicación de un caso. Rev Esp Med Quir 2010; 15: 97-100.

  12. Zantvoord Y, van der Weiden RM, Van Hoof MH. Transmural migration of retained surgical sponge: A systematic review. Obstet Gynecol Surv 2008; 63: 465-471.

  13. Aranaz-Andrés JM, Aibar-Remón C, Limón-Ramírez R, Amarilla A, Restrepo FR, Urroz O, et al. Prevalence of adverse events in the hospitals of five Latin American countries: results of the ‘Iberoamerican study of adverse events’ (IBEAS) BMJ Qual Saf Publicado en línea Junio 28, 2011; doi:10.1136/bmjqs.2011.051284

  14. Gibbs VC. Retained surgical items and minimally invasive surgery. World J Surg 2011; 35: 1532-1539.

  15. McIntyre LK, Jurkovich GJ, Gunn ML, Maier RV. Gossypiboma: tales of lost sponges and lessons learned. Arch Surg 2010; 145: 770-775.

  16. Nothing Left Behind website (2010) http://www.nothingleftbehind.org. Consultado 28 de septiembre de 2011.

  17. Association of Perioperative Registered Nurses (2010) Recommended practices for prevention of retained surgical items. In: Perioperative standards and recommended practices. AORN, Denver, CO. http://www.aorn.org Consultado 28 de septiembre de 2011.

  18. Macario A, Morris D, Morris S. Initial clinical evaluation of a handheld device for detecting retained surgical gauze sponges using radiofrequency identification technology. Arch Surg 2006; 141: 659-662.

  19. Vincent CH. Understanding and responding to adverse events. N Engl J Med 2003; 348: 1051-1056.

  20. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizart AH, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009; 360: 491-499.






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