Natural history of the retained surgical sponge

Retained surgical sponge is an infrequently reported condition that may be recognized incidentally during the early postoperative period, produce serious complications, or remain dormant for years. Clinical manifestations of the retained surgical sponge are a function of bacterial contamination and of the location of the sponge within the body cavity. Few sequelae follow external extrusion but internal erosion may lead to abscess, fistulas, and intestinal obstruction. Prevention requires constant sensitivity of the surgeon to this potential threat to the safe practice of surgery. The surgeon must account for an incorrect sponge count by adequate examination of the operative field and by roentgenographic studies when the issue remains in doubt. A correct sponge count does not fully preclude a retained sponge, however, and inspection of the operative field should be routine in all patients at risk.