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The Role Of Radio Frequency Identification Embedded Surgical Sponges In Preventing Retained Foreign Bodies: A Prospective Evaluation In Patients Undergoing Emergency Surgery
Kenji Inaba, Obi Okoye*, Hande Aksoy*, Dimitra Skiada*, Glenn Ault*, Lydia Lam*, Elizabeth Benjamin*, Demetrios Demetriades
LAC+USC Medical Center, Los Angeles, CA

OBJECTIVE(S):
Emergency surgery patients are at high risk for retained foreign bodies (RFB). This study prospectively evaluated the ability of Radio-Frequency Identification (RFID) sponges to mitigate the occurrence of this “never event”.
METHODS:
All emergent trauma and non-trauma cavitary operations (01/2010-12/2014) were prospectively enrolled. For damage control, only the definitive closure was included. RFID sponges were used exclusively throughout the study period. Prior to closure, the sponge/instrument count was followed by RFID scanning and x-ray evaluation for retained sponges. RFB and near-misses averted by using the RFID system were analyzed.
RESULTS:
2051 patients (mean[SD], 41.2[16.3] years [range:1-101], 72.2% male, 46.8% trauma) underwent 2148 operations (1921-laparotomy, 197-thoracotomy, 30-sternotomy). RFID detected retained sponges in 11 (0.5%) patients (81.8%-laparotomy, 18.2%-sternotomy). All post-closure x-rays were negative, no retained sponges were missed by RFID. Median BMI 28.9 (range:23-42, 29.3[5.9]), EBL 1.0L (5.6[8.2]), OR time 160 mins (range:71-869, 235[221.9]). Closure occurred after hours (0600-1800) in 54.5%. In 36.4%, the sponge count was correct and in 45.5% not performed due to urgency of the case. The additional cost of using RFID embedded disposables was C:\inetpub\wwwroot\WebsiteHosting\ASA\website\meeting\abstracts\2016\22.cgi.17 for a 4X18 laparotomy sponge and C:\inetpub\wwwroot\WebsiteHosting\ASA\website\meeting\abstracts\2016\22.cgi.46 for 16ply, 4X8.
CONCLUSIONS:
Emergent surgical procedures are high-risk for retained sponges, even when sponge counts are performed. Implementation of a RFID system was effective in preventing this complication and should be considered for emergent operations in an effort to improve patient safety.


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