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International Journal of Molecular... Feb 2021Tissue engineering (TE) is the approach to combine cells with scaffold materials and appropriate growth factors to regenerate or replace damaged or degenerated tissue or... (Review)
Review
Tissue engineering (TE) is the approach to combine cells with scaffold materials and appropriate growth factors to regenerate or replace damaged or degenerated tissue or organs. The scaffold material as a template for tissue formation plays the most important role in TE. Among scaffold materials, silk fibroin (SF), a natural protein with outstanding mechanical properties, biodegradability, biocompatibility, and bioresorbability has attracted significant attention for TE applications. SF is commonly dissolved into an aqueous solution and can be easily reconstructed into different material formats, including films, mats, hydrogels, and sponges via various fabrication techniques. These include spin coating, electrospinning, freeze drying, physical, and chemical crosslinking techniques. Furthermore, to facilitate fabrication of more complex SF-based scaffolds with high precision techniques including micro-patterning and bio-printing have recently been explored. This review introduces the physicochemical and mechanical properties of SF and looks into a range of SF-based scaffolds that have been recently developed. The typical TE applications of SF-based scaffolds including bone, cartilage, ligament, tendon, skin, wound healing, and tympanic membrane, will be highlighted and discussed, followed by future prospects and challenges needing to be addressed.
Topics: Absorbable Implants; Animals; Biocompatible Materials; Biopolymers; Bioprinting; Extracellular Matrix; Fibroins; Humans; Hydrogels; Insecta; Materials Testing; Mechanical Phenomena; Organ Specificity; Protein Conformation; Regeneration; Species Specificity; Spiders; Surgical Sponges; Tissue Engineering; Tissue Scaffolds
PubMed: 33540895
DOI: 10.3390/ijms22031499 -
Open Access Macedonian Journal of... Mar 2017The problem of retained surgical bodies (RSB) after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences... (Review)
Review
The problem of retained surgical bodies (RSB) after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.
PubMed: 28293325
DOI: 10.3889/oamjms.2017.005 -
The Thoracic and Cardiovascular Surgeon Oct 2022Gossypiboma, a retained nonabsorbable surgical sponge, is a major safety issue despite being infrequent, causing serious malpractice debates. In addition to this, it may...
Gossypiboma, a retained nonabsorbable surgical sponge, is a major safety issue despite being infrequent, causing serious malpractice debates. In addition to this, it may mimic a range different disease within the thorax and even have unpleasant clinical presentations even after years.In this article, we report four gossypiboma cases with nonspecific clinical presentations to emphasize the importance of keeping this diagnosis in mind with all patients who have had a previous operation.
Topics: Foreign Bodies; Humans; Surgical Sponges; Treatment Outcome
PubMed: 34376001
DOI: 10.1055/s-0041-1731779 -
Diagnostic and Interventional Radiology... Mar 2010Gossypiboma is a mass formed by a retained surgical sponge and reactive tissue. The cases with gossypiboma are usually asymptomatic or with nonspecific symptoms, which...
Gossypiboma is a mass formed by a retained surgical sponge and reactive tissue. The cases with gossypiboma are usually asymptomatic or with nonspecific symptoms, which delay diagnosis for months or years after surgery. We describe imaging findings in a 43-year-old woman with a symptomatic retained surgical sponge in a lumbar laminectomy site. Ultrasonography, computed tomography, magnetic resonance imaging (MRI), and diffusion-weighted MRI were performed. Gossypiboma should be considered in the differential diagnosis of a mass in a patient with a history of prior surgery. Diffusion-weighted MRI may provide important data for differential diagnosis of gossypiboma. With diffusion-weighted MRI, gossypiboma may be distinguished from an abscess by its low signal intensity and increased apparent diffusion coefficient (ADC) as compared to high signal intensity with low ADC in cases of abscess.
Topics: Adult; Diffusion Magnetic Resonance Imaging; Female; Foreign Bodies; Humans; Laminectomy; Lumbosacral Region; Magnetic Resonance Imaging; Surgical Sponges; Tomography, X-Ray Computed; Ultrasonography
PubMed: 19813177
DOI: 10.4261/1305-3825.DIR.1183-07.1 -
Annals of the Royal College of Surgeons... Mar 2013Retained sponges and instruments (RSI) due to surgery are a recognised medical 'never event' and have catastrophic implications for patients, healthcare professionals... (Review)
Review
INTRODUCTION
Retained sponges and instruments (RSI) due to surgery are a recognised medical 'never event' and have catastrophic implications for patients, healthcare professionals and medical care providers. The aim of this review was to elucidate the extent of the problem of RSI and to identify preventative strategies.
METHODS
A comprehensive literature search was performed on MEDLINE(®), Embase™, the Science Citation Index and Google™ Scholar for articles published in English between January 2000 and June 2012. Studies outlining the incidence, risk, management and attempts to prevent RSI following surgical intervention were retrieved.
RESULTS
The overall incidence of RSI is low although its incidence is substantially higher in operations performed on open cavities. Sponges are the most commonly retained item when compared with needles and instruments. Clinical presentation is varied, leading to avoidable morbidity, and the error is indefensible medicolegally. Risk factors include emergency operations, operations involving unexpected change in procedure, raised body mass index, and a failure to perform accurate sponge and instrument counts. The existing strategy for prevention is manual counting of sponges and instruments undertaken by surgical personnel. This, however, is fallible. Computer assisted counting of sponges using barcodes and gauze sponges tagged with a radiofrequency identification device aiding manual counting have been trialled recently, with success.
CONCLUSIONS
Vigilance among operating theatre personnel is paramount if RSI is to be prevented. Prospective multicentre trials to assess efficacy of new technologies aiding manual counting should be undertaken if this medical error is to be eliminated completely.
Topics: Early Diagnosis; Foreign Bodies; Humans; Incidence; Medical Errors; Needles; Risk Factors; Surgical Instruments; Surgical Sponges
PubMed: 23484986
DOI: 10.1308/003588413X13511609957218 -
Radiology Case Reports 2011A retained surgical sponge (gossypiboma) is a rare but serious complication of surgery; most cases occur after intra-abdominal surgery. Intrathoracic gossypiboma is...
A retained surgical sponge (gossypiboma) is a rare but serious complication of surgery; most cases occur after intra-abdominal surgery. Intrathoracic gossypiboma is extremely rare, with only a handful of reported cases, most of which are associated with pulmonary surgery (1, 2, 3, 4, 5). Although almost all surgical sponges contain a radiopaque marker, usually a barium sulfate filament, detection of a retained sponge can be very difficult, particularly when its presence is not suspected. We present a case of anterior mediastinal gossypiboma following repair of subaortic stenosis in which the sponge marker was mistaken for a sternal suture wire on chest radiographs.
PubMed: 27307890
DOI: 10.2484/rcr.v6i1.481 -
BMJ Case Reports Jun 2013Gossypiboma, a retained surgical sponge, is a rare complication that can occur after any type of surgery. Despite the precautions, the retention of foreign bodies still...
Gossypiboma, a retained surgical sponge, is a rare complication that can occur after any type of surgery. Despite the precautions, the retention of foreign bodies still occurs. We describe a case of a 33-year-old woman with epigastric pain. She was initially diagnosed with acute cholangitis with choledocholithiasis. Although common bile duct stone was successfully removed endoscopically, her epigastric pain did not completely subside. She had undergone an emergency caesarean section at a suburban maternity hospital 6 weeks prior to the referral. A contrast-enhanced CT revealed an encapsulated mass showing a spongiform pattern with fluids and gas bubbles inside, and gossypiboma was suspected. A retained surgical sponge without radiopaque markers was removed surgically. Except for a wound infection, the postoperative course was uneventful. Gossypiboma should always be considered in the differential diagnosis of indeterminate abdominal pain, infection or a mass in patients with a prior surgical history.
Topics: Abdominal Pain; Female; Foreign Bodies; Humans; Surgical Sponges; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 23813518
DOI: 10.1136/bcr-2013-010059 -
BMJ Case Reports Jan 2014Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include...
Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include adhesions, abscess formation and subsequent infections. Gossypiboma occurs as a result of not using radio-opaque sponges, poorly performed sponge counts, inadequate wound explorations on suspicion and misread intraoperative radiographs. Therefore, this event can be avoided if strict preventive measures are taken. Moreover, further complications can be avoided following the correct and early diagnosis of gossypiboma. Gossypiboma is an important topic as it carries great medicolegal consequences for the surgeon. We have presented three cases of intrathoracic gossipiboma following previous cardiothoracic surgeries. They presented years after their surgeries, with features varying from patient to patient, ranging from cough and fever to no sypmtoms at all. CT scan only showed a mass lesion in all cases, therefore we proceeded for CT-guided biopsy which was also found to be inconclusive. It was only after entering the thoracic cavity via video-assisted thoracoscopy/thoracotomy that the diagnosis was made and sponges were taken out successfully. All our cases recovered with no further complications.
Topics: Aged; Coronary Artery Bypass; Diagnosis, Differential; Foreign Bodies; Heart Valve Prosthesis Implantation; Humans; Lung; Male; Mediastinum; Middle Aged; Mitral Valve Insufficiency; Postoperative Complications; Reoperation; Surgical Sponges; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed
PubMed: 24403384
DOI: 10.1136/bcr-2013-201814 -
Surgical Innovation Dec 2020Retention of surgical sponges in patients is a relatively frequent medical malpractice. To prevent it, the surgical sites are scanned using X-ray. However, using...
Retention of surgical sponges in patients is a relatively frequent medical malpractice. To prevent it, the surgical sites are scanned using X-ray. However, using radiography in the operation room induces X-ray exposure for both patients and staff. To prevent such issues, a novel sponge counting system was developed. Each surgical sponge used in common hospitals is composed of single radiopaque fibers. The proposed system scans surgical sponges to estimate their fiber length (EFL) and returns the number of it. In this study, an optimal image acquisition protocol was determined that allows an accurate count of sponges. X-ray doses and multi-angle image procedures were tested. Measurement trials were performed and compared for both dry and blood-soaked sponges. As a result, the X-ray dose of 50 kV and 600 μA and the acquisition of 180 images per sample yielded an accurate EFL. The 180-image protocol achieved good performance in this study and allowed counting of one package of 10 sponges in 226 seconds. For these settings, a significant correlation was found between the actual number of sponges and the estimated fiber lengths. Additionally, the performance of the system was similar for either dry or blood-soaked items. The proposed system could accurately count surgical sponges and is a promising option in preventing the accidental retention of surgical sponges.
Topics: Foreign Bodies; Humans; Surgical Sponges
PubMed: 32723214
DOI: 10.1177/1553350620943349 -
Journal of the Chinese Medical... Nov 2007Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary...
Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.
Topics: Aged; Aged, 80 and over; Female; Foreign Bodies; Humans; Medical Errors; Surgical Sponges
PubMed: 18063507
DOI: 10.1016/S1726-4901(08)70051-0