Gossypiboma Post Cesarean Section: Patient Safety Review

Abstract

Background: Operations in the pelvic area including cesarean section are often followed by unwanted events in the form of missing surgical instruments. The surgical device that is most often left behind during operations is surgical gauze and is known as a gossypiboma. Surgical gauze is often left in body cavities such as the peritoneum, pelvis, and retroperitoneal spaces. This surgical gauze can remain in the body for days, months, or even years before manifesting clinically. A granulomatous reaction around the surgical gauze may produce exudate followed by the formation of an abscess or fibrotic mass. Objective: To see the aspect of patient safety in cases of gossypiboma after cesarean section. Methods: Serial report of gossypiboma cases after cesarean section. Results and Discussion: Three cases of gossyfiboma were reported after cesarean section in Bali in 2017-2018. The diagnosis is made clinically according to complaints, and history of cesarean section and supported by supporting examinations such as BOF (Book-on-Filter), Ultra Sonography, and Computerized Tomography-Scan. Various surgical procedures were performed including sub-total colectomy laparotomy, right hemicolectomy laparotomy, and Hartman procedure laparotomy. All operations went well with good results too. Patient safety approaches and procedures must be carried out strictly to prevent a recurrence. Conclusion: Reports of three cases of gossypiboma after caesarean section are strongly related to patient safety procedures that are not performed in the operating room.