Assigning Responsibility for Gossypiboma (Abdominal Retained Surgical Sponges) in Operating Room

• Main Authors: Amjad Siraj Memon, Naveed A Khan, Khursheed A Samo, Amna Bhatti, Rekha Jiswant Kumar, Maryum Nouman
• Format: Article
• Language: English
• Published: Dow University of Health Sciences 2012-12-01
• Series: Journal of the Dow University of Health Sciences
• Subjects: surgical gauze; medical ethics
• Online Access: http://www.jduhs.com/index.php/jduhs/article/view/10

Background and objective Retained surgical gauze is a well known but less frequently reported surgical error. Several factors can lead to this mishap. It remains under-reported due to medico legal issues associated with its occurrence. This study was carried out to determine the view of health care providers at risk of committing this error regarding accidental abandonment of surgical gauze in surgical patients. Type Cross sectional study. Place: Civil Hospital Karachi. Method A questionnaire was distributed among the participants by investigators. The participants were divided into categories of faculty, surgical trainees and scrub Nurses. The responses of the participants were entered and analyzed on SPSS version 11. Results A total of 254 participants completed the survey form. Majority of the participants were trainees and scrub nurses.i.e.159 (62.5%) and 51(20.1%) respectively. Quite a few participants supported the idea of introduction of medical ethics in curriculum 108 (42.5%), active legislation regarding abandonment of swabs by PMDC 52 (20.4%), application of white boards in swab counting i.e. 80 (31.4%), and barring of surgeon if found involved in such accident 53 i.e. (20.8%). Most participants thought swab counting was practiced in the operation theater (195/254)(76.7%) and that radio opaque swabs should be used (182/254)(71.6%). Most participants thought it was the responsibility of the scrub nurse to count the swabs (156/254) (61.4%). The two most common responses by participants in an event that a swab was found in a patient post operatively were, to make an attempt to bury the issue between the surgeon and scrub nurse (129/254) (50.7%) and to inform the hospital administration (74/254) (29.1%) respectively. Conclusion Retained surgical gauze is an important surgical error in terms of medico-legal issues and patient morbidity. Health care providers fear its’ outcomes and so standard guidelines need to be in practice to prevent patients and health care providers from this mistake and its adverse outcomes.