Stawicki S P, Evans D C, Cipolla J, Seamon M J, Lukaszczyk J J, Prosciak M P, Torigian D A, Doraiswamy V A, Yazzie N P, Gunter O L, Steinberg S M
Department of Surgery, Division of Critical Care, Trauma, and Burn, The Ohio State University Medical Center, N-717 Doan Hall, 410 West 12th Avenue, Columbus, OH 43210, USA.
Scand J Surg. 2009;98(1):8-17. doi: 10.1177/145749690909800103.
Given the increasing complexity of both the modern health care environment and the overall patient population, reduction of medical errors is a high priority task for health policy makers and medical/surgical community alike. The problem of retained surgical foreign bodies (RSFB) has existed ever since the humans first performed surgical procedures. Retained surgical foreign bodies continue to be a significant problem with an incidence between 0.3 and 1.0 per 1,000 abdominal operations. Retained surgical foreign bodies have the potential to cause harm to the patient and carry profound professional and medico-legal consequences to surgical trainees, surgical practitioners, hospitals, and health systems. Currently, there are no known methods of entirely eliminating the occurrence of RSFB. In this manuscript, the authors discuss the available evidence with regards to risk factors associated with RSFB as well as methods of minimizing the incidence of RSFB. Modern technological advances designed to decrease the incidence of RSFB (radio-frequency tagging of surgical sponges) and improved perioperative patient processing (multiple 'checks and balances' and better provider-to-provider communication) are reviewed. The authors also explore the relationship between RSFB and surgical training with emphasis on education in early recognition, prevention, and focus on team-oriented training strategies.
鉴于现代医疗环境和总体患者群体日益复杂，减少医疗差错是卫生政策制定者和医疗/外科界的一项高度优先任务。自从人类首次进行外科手术以来，手术中遗留异物（RSFB）的问题就一直存在。手术中遗留异物仍然是一个重大问题，每1000例腹部手术的发生率在0.3至1.0之间。手术中遗留异物有可能对患者造成伤害，并给外科实习生、外科医生、医院和卫生系统带来严重的专业和法律后果。目前，尚无完全消除手术中遗留异物发生的已知方法。在本手稿中，作者讨论了与手术中遗留异物相关的危险因素的现有证据以及将手术中遗留异物发生率降至最低的方法。回顾了旨在降低手术中遗留异物发生率的现代技术进展（手术海绵的射频标记）和改进的围手术期患者处理（多重“制衡”和更好的提供者之间的沟通）。作者还探讨了手术中遗留异物与外科培训之间的关系，重点是早期识别、预防教育以及注重团队导向的培训策略。
