An infrequent but alarming cause of postoperative abscesses is retention of surgical foreign bodies. The objects include various types of sponges, pads, drains, forceps, needles, metallic irrigator tips, and tantalum mesh.59,60 A laparotomy sponge is the most commonly retained surgical foreign body because of the frequency of its use and the depth of the cavities into which it is placed.59 The diagnosis of retained towels or sponges in the abdomen is usually difficult because of the rarity and unexpected nature of the complication and because symptoms typically appear only months to many years after surgery.
Surgical sponges are usually made of inert cotton and do not undergo decomposition or biochemical reac-tion59; however, in some cases, they may become distorted by folding, twisting, and partial disintegration.61 Occasionally, they may cause no apparent problem other than medicolegal liability. Retained sponges may stimulate an inflammatory reaction, with development offibrosis, adhesions, and foreign-body, granuloma, that can result in bowel obstruction.61-63 The retained sponge may also serve as the nidus for subsequent abscess for-mation.60 In addition, a sinus tract and fistula into a hollow viscus may form in an attempt by the body to extrude the foreign material.63
Because of past difficulty in recognizing retained surgical sponges, most institutions now use only sponges that have been manufactured with radiopaque mark-ers.59 Detection of the opaque marker may be hindered text continues on page 106
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.