A surgical sponge is a specialized sponge or pad used in surgery. Also known as a lap sponge, a surgical sponge is used to absorb liquids from a surgical site. It may be used in combination with suction to keep a surgical site clear, by a surgeon working to control bleeding, and in a number of other applications. Like other things used in surgery, sponges are designed to be sterile; they come in their own sterile packaging and can be safely autoclaved. They are generally disposable and discarded after surgery in biohzard containers which hold other disposable surgical instruments and equipment.
The surgical sponge carries a legendary status among people who are worried about objects being left inside patients during surgery. In fact, the sponge has such a lengthy history of ending up on the wrong side of the stitches after a surgery that there's even a special term for a situation in which a surgical sponge is left inside a patient: gossypiboma. Sponges are left behind for a variety of reasons, ranging from small sizes which allow some sponges to slip into a hidden area, to a surgery performed in an emergency, when the surgeon and the surgical team may be more worried about getting the patient through the surgery than anything else.
There are several techniques which can be used to control surgical sponges to reduce the risk of being left in the patient. The simplest involves counting all sponges and instruments, sometimes with the assistance of a barcode scanner. In this case, everything is counted or scanned in before the surgery, and counted or scanned out afterwards. This allows the surgical team to identify missing instruments and sponges immediately.
Many manufacturers embed a strip of radio-opaque material into every sponge they produce. This means that if a sponge is left in the body, an x-ray machine can be used to identify the sponge and pinpoint the location so it can be removed. This system is not foolproof, however, as sometimes the strip may be hidden behind a structure such as a bone, rendering the sponge effectively invisible.
Other technology designed to prevent the dreaded retained surgical sponge includes the addition of an RFID tag to each sponge. The tag can alert the surgical team when a sponge is left inside a patient, and can also be used when sponges and tools are counted out after a procedure.
