Lazzaro Alessandra, Corona Arianna, Iezzi Luca, Quaresima Silvia, Armisi Luca, Piccolo Ilaria, Medaglia Carlo Maria, Sbrenni Sergio, Sileri Pierpaolo, Rosato Nicola, Gaspari Achille Lucio, Di Lorenzo Nicola
1 University of Tor Vergata, Rome, Italy.
2 5-Emme Informatica Spa, Rome, Italy.
Surg Innov. 2017 Jun;24(3):268-275. doi: 10.1177/1553350617690608. Epub 2017 Feb 8.
A retained surgical item in patients (gossypiboma) is a persisting problem, despite consistent improvements and existing guidelines in counting instruments and sponges. Previous experiences with radiofrequency identification technology (RFID) tracking sponges show that it could represent an innovation, in order to reduce the criticism and increase the effectiveness during surgical procedures. We present an automated system that allows reduction of errors and improves safety in the operating room.
The system consists of 3 antennas, surgical sponges containing RFID tags, and dedicated software applications, with Wi-Fi real-time communication between devices. The first antenna provides the initial count of gauzes; the second a real-time counting during surgery, including the sponges thrown into the kick-bucket; and the third can be used in the event of uneven sponge count. The software allows management at all stages of the process.
In vitro and in vivo tests were performed: the system provided excellent results in detecting sponges in patients' body. Hundred percent retained sponges were detected correctly, even when they were overlapped. No false positive or false negative was recorded. The counting procedure turned out to be more streamlined and efficient and it could save time in a standard procedure.
The RFID system for sponge tracking was shown to be experimentally a reliable and feasible method to track sponges with a full detection accuracy in the operating room. The results indicate the system to be safe and effective with acceptable cost-effective parameters.
尽管在器械和纱布清点方面持续改进并制定了现有指南,但患者体内遗留手术物品(棉球瘤)仍是一个长期存在的问题。先前使用射频识别技术(RFID)追踪纱布的经验表明,该技术可能是一项创新,有助于减少手术过程中的失误并提高效率。我们展示了一种可减少手术室差错并提高安全性的自动化系统。
该系统由3个天线、带有RFID标签的手术纱布以及专用软件应用程序组成,设备之间通过Wi-Fi进行实时通信。第一个天线提供纱布的初始计数;第二个在手术期间进行实时计数,包括扔进踢桶的纱布;第三个在纱布计数出现差异时使用。该软件允许对过程的所有阶段进行管理。
进行了体外和体内测试:该系统在检测患者体内的纱布方面取得了优异结果。即使纱布相互重叠,也能100%正确检测出遗留的纱布。未记录到假阳性或假阴性情况。计数程序变得更加简化和高效,在标准手术流程中可以节省时间。
实验表明,用于纱布追踪的RFID系统是一种可靠且可行的方法,在手术室中追踪纱布具有完全的检测准确性。结果表明该系统安全有效,具有可接受的性价比参数。