Intra-abdominal Gossypibomas: Clinical Manifestations, Risk Factors and Prevention

Gossypibomas are masses formed by accidentally retained cotton matrix anywhere in the body, following a surgical procedure. It has catastrophic effects not only on patients but also on the health professionals and health care providers. We have retrospectively reviewed 6 patients of intra-abdominal gossypibomas who had presented over a 10-year period, to our centre. The relevant preoperative and intraoperative details along with the clinical course of these patients have been described. Through the management of these patients, we have shared our experience in relation to the clinical presentations, probable risk factors, and radiological features for diagnosis and treatment, along with the ethical and medicolegal implications of the issue. The safety measures that exist are also reviewed. An intraoperative "correct count" during a surgical operation does not always exclude the possibility of a gossypiboma or a retained foreign body. Increased awareness, familiarity with the existing local protocols, and strict adherence of these protocols, along with open communication, are essential in minimizing the frequency of such events. A concerted effort by the entire surgical team is crucial. Newer technology such as barcoding of sponges and radiofrequency identification (RFID) tagging may help decrease the occurrence of this problem.