Abstract
Background
Unintentional retention of foreign bodies in surgery is uncommon but potentially serious. Published data regarding the consequence of retained surgical needles is sparse. We aimed to characterize lost surgical needles at our institution. Secondarily, we aimed to determine whether or not retained microsurgical needles can be reliably detected.
First published: 11 September 2020 https://doi.org/10.1111/ans.16302 By A. McCombe MD; A. Heald MBBS; M. Wagels PhD, FRACS (Plast).
Methods
Reports of missing surgical needles at our institution were reviewed. Surgical needles of relevant sizes were scattered across an anthropomorphic model at representative anatomical locations. Fluoroscopic images of the field were acquired using two resolution settings. Medical staff in our department attempted to locate needles in these images.
Results
A total of 46 323 procedures were performed in the main theatres in the 2.5‐year period. Sixty‐two needles were reported as missing. No patient harm was documented. Needles of chord length 16 mm (5–0) or greater were always detected. High‐resolution fluoroscopy improves detection of needles with chord lengths of 9.3 (7–0) or 6.6 mm (9–0). Needles are consistently better detected in the lower limb for needles of chord length greater than 6.6 mm (9–0). Senior observers under ideal conditions can detect 7.1% of smaller needles.
Conclusion
When a needle is lost during surgery, consider the following before ordering fluoroscopy. Needles of chord length greater than 13 mm (6–0) should be reliably detected whilst 3.8 mm (10–0) needles will not. For sizes in between, ideal conditions for detection may include an operating field in the lower limb, high‐resolution fluoroscopy and a senior observer. It may not be necessary or cost effective to identify microsurgical needles with fluoroscopy.