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. 2013 Mar;95(2):87–92. doi: 10.1308/003588413X13511609957218

Table 5.

Advantages and disadvantages of strategies to prevent retained sponges and instruments

Preventive strategy Advantages Disadvantages
Counting of sponges and instruments 10

  • Standard procedures and protocols in place

  • Labour intensive

  • Error prone
Intraoperative x-ray screening 10

  • Negligible clinical harm

  • Easy to deploy

  • Poor quality films

  • Poor yield
Routine postoperative high-resolution x-ray surveillance 9

  • Negligible clinical harm

  • High set up costs

  • Logistics

  • False negative rate 10–25%

  • Unnecessary radiation exposure
Sponges tagged with radiofrequency identification chip 28

  • High detection accuracy under test conditions

  • Efficacy unproven

  • No RCTs yet

  • Prone to errors
Barcoded or data matrix coded sponges as adjunct to existing counting protocols 29,30

  • Technology in use in medicine

  • Improved detection of miscounted / misplaced sponges in RCT

  • Strategy implemented in a single institution with positive results

  • Increase in time to count sponges

  • Learning curve to adapt to new technology

  • Cost vs benefit needs to be determined appropriately

RCT = randomised controlled trial