Abstract

this study aims to explore the experience of Brazilian surgeons on Unintentionally Retained Foreign Bodies (RFB) after surgical procedures. A questionnaire was sent to surgeons by electronic mail, between March and July 2012. The questions analyzed their experience with foreign bodies (FB), foreign bodies' types, clinical manifestations, diagnoses, risk factors and legal implications. in the 2872 eligible questionnaires, 43% of the surgeons asserted that they had already left FB and 73% had removed FB in one or more occasions, totalizing 4547. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year and 14% remained asymptomatic. Among doctors with less than five years after graduation, 36% had already left a FB. The most frequently surgical procedures mentioned were the elective (57%) and routine (85%) ones. Emergency (26%), lack of counting (25%) and inadequate conditions of work contributed (12.5%) to the occurrence. In 46% of the cases patients were alerted about the FB, and 26% of them sued the doctors or the institution. challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

Highlights

  • Retained Foreign Bodies (RFB) causes 70% of reinterventions[1], reaching 80% morbidity and 35% mortality[2,3], in addition to significant medical and legal costs[4,5]

  • In order to make progress in understanding their occurrence, covering a greater number of cases, this study will examine the experience of surgeons with RFB, assessing some of their characteristics and consequences

  • When we correlated the time for foreign bodies (FB) diagnosis to the clinical picture, we found that 96% of patients had some symptom two to six months after surgery, whereas 23% were asymptomatic in the period of more than five years after the procedure

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Summary

Introduction

Retained Foreign Bodies (RFB) causes 70% of reinterventions[1], reaching 80% morbidity and 35% mortality[2,3], in addition to significant medical and legal costs[4,5]. RFB still represents a problem without solution[6]. The sporadic nature of this event (1:1000 to 1:2000)[7,8,9], as well as the stigma of medical malpractice that follows it, still hinder its report and understanding, which is based on case-control studies and limited series. In order to make progress in understanding their occurrence, covering a greater number of cases, this study will examine the experience of surgeons with RFB, assessing some of their characteristics and consequences

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