Gossypiboma, textiloma or more broadly Retained Foreign Object (RFO) is the technical term for surgical complications resulting from foreign materials, such as a surgical sponge, accidentally left inside a patient's body.
Gossypiboma, textiloma or more broadly Retained Foreign Object (RFO) is the technical term for surgical complications resulting from foreign materials, such as a surgical sponge, accidentally left inside a patient's body.
Gossypiboma is derived from Latin gossypium (cotton) and Swahili "boma" (place of concealment), meaning a tumor or growth. [1] Gossypiboma describes a mass within a patient's body comprising a cotton matrix surrounded by a foreign body granuloma. [2] [3]
Textiloma is derived from textile (surgical sponges have historically been made of cloth), and is used in place of gossypiboma due to the increasing use of synthetic materials in place of cotton. [2]
The actual incidence of gossypiboma is difficult to determine, possibly due to a reluctance to report occurrences arising from fear of legal repercussions, but retained surgical sponges is reported to occur once in every 3000 to 5000 abdominal operations [3] and are most frequently discovered in the abdomen. [4] The incidence of retained foreign bodies following surgery has a reported rate of 0.01% to 0.001%, of which gossypibomas make up 80% of cases. [2]
Gossypibomas can often present, clinically or radiologically, similar to tumors and abscesses, with widely variable complications and manifestations, making diagnosis difficult and causing significant patient morbidity. [4] Two major types of reaction occur in response to retained surgical foreign bodies. In the first type, an abscess may form with or without a secondary bacterial infection. The second reaction is an aseptic fibrinous response, resulting in tissue adhesions and encapsulation and eventually foreign body granuloma. [2] Symptoms may not present for long periods of time, sometimes months or years following surgery. [2]
To prevent gossypiboma, sponges are counted by hand before and after surgeries. This method was codified into recommended guidelines in the 1970s by the Association of periOperative Registered Nurses (AORN). [5] Four separate counts are recommended: the first when instruments and sponges are first unpackaged and set up, a second before the beginning of the surgical procedure, a third as closure begins, and a final count during final skin closure. [6] Other guidelines have been promoted by the American College of Surgeons and the Joint Commission. [7]
In most countries, surgical sponges contain radiopaque material that can be readily identified in radiographic and CT images, facilitating detection. [2] In the United States, radiopaque threads impregnated into surgical gauzes were first introduced in 1929 and were in general use by about 1940. [8] Some surgeons recommend routine postoperative X-ray films after surgery to reduce the likelihood of foreign body inclusion. [8]
An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends beyond the swelling. Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger. A cyst is related to an abscess, but it contains a material other than pus, and a cyst has a clearly defined wall.
Surgery is a medical specialty that uses manual and/or instrumental techniques to physically reach into a subject's body in order to investigate or treat pathological conditions such as a disease or injury, to alter bodily functions, to improve appearance, or to remove/replace unwanted tissues or foreign bodies. The subject receiving the surgery is typically a person, but can also be a non-human animal.
A granuloma is an aggregation of macrophages that forms in response to chronic inflammation. This occurs when the immune system attempts to isolate foreign substances that it is otherwise unable to eliminate. Such substances include infectious organisms including bacteria and fungi, as well as other materials such as foreign objects, keratin, and suture fragments.
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Tonsil stones, also known as tonsilloliths, are mineralizations of debris within the crevices of the tonsils. When not mineralized, the presence of debris is known as chronic caseous tonsillitis (CCT). Symptoms may include bad breath, foreign body sensation, sore throat pain or discomfort with swallowing, and cough. Generally there is no pain, though there may be the feeling of something present. The presence of tonsil stones may be otherwise undetectable, however some people have reported seeing white material in the rear of their throat.
A surgical technologist, also called a scrub, scrub tech, surgical technician, or operating department practitioner or operating room technician, is an allied health professional working as a part of the team delivering surgical care. Surgical technologists are members of the surgical team. The members of the team include the surgeon, surgeon's assistant, circulator nurse and anesthesia provider. They possess knowledge and skills in sterile and aseptic techniques. There are few mandatory professional requirements for surgical technologists, and the scope of practice varies widely across countries and jurisdictions. Surgical technologists attend junior colleges and technical schools, and many are trained in military schools. In the military they perform the duties of both the circulator and the scrub. The goal is for surgical technologists to be able to anticipate the next move the surgeon is going to make in order to make the procedure as smooth and efficient as possible. They do this by having knowledge of hundreds of surgical procedures and the steps the surgeon needs to take in order to complete the procedure, including the very wide range of surgical instruments they may need. Specialties can include, but are not limited to, the following: genitourinary, obstetrics and gynaecology, urology, ENT, plastics, general, orthopedics, neurology, and cardiovascular. They only work in surgical or perioperative areas and are highly specialized. Surgical technologist is the proper term for a two-year program which earns a degree in applied sciences. The profession is up and coming and highly in demand.
Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle. The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods. The hyponym operculitis technically refers to inflammation of the operculum alone.
Orbital cellulitis is inflammation of eye tissues behind the orbital septum. It is most commonly caused by an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood. It may also occur after trauma. When it affects the rear of the eye, it is known as retro-orbital cellulitis.
Atlanto-occipital dislocation, orthopedic decapitation, or internal decapitation describes ligamentous separation of the spinal column from the skull base. It is possible for a human to survive such an injury; however, 70% of cases result in immediate death. It should not be confused with atlanto-axial dislocation, which describes ligamentous separation between the first and second cervical vertebra.
Post-vasectomy pain syndrome (PVPS) is a chronic and sometimes debilitating genital pain condition that may develop immediately or several years after vasectomy. Because this condition is a syndrome, there is no single treatment method, therefore efforts focus on mitigating/relieving the individual patient's specific pain. When pain in the epididymides is the primary symptom, post-vasectomy pain syndrome is often described as congestive epididymitis.
Gauze sponges are disposable medical supplies commonly used in medicine and surgery. They are ordinarily made of gauze and are used to absorb blood and other fluids as well as clean wounds. When used in surgery, they are called surgical sponges.
Also called Zuska's disease, subareolar abscess is a subcutaneous abscess of the breast tissue beneath the areola of the nipple. It is a frequently aseptic inflammation and has been associated with squamous metaplasia of lactiferous ducts.
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Products of conception, abbreviated POC, is a medical term used for the tissue derived from the union of an egg and a sperm. It encompasses anembryonic gestation which does not have a viable embryo.
Periapical periodontitis or apical periodontitis (AP) is an acute or chronic inflammatory lesion around the apex of a tooth root, most commonly caused by bacterial invasion of the pulp of the tooth. It is a likely outcome of untreated dental caries, and in such cases it can be considered a sequela in the natural history of tooth decay, irreversible pulpitis and pulpal necrosis. Other causes can include occlusal trauma due to 'high spots' after restoration work, extrusion from the tooth of root filling material, or bacterial invasion and infection from the gums. Periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp, or into a periapical cyst, where an epithelial lined, fluid-filled structure forms.
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