Sponge pieces as retractors in neurosurgical interventions

Background: Different retractors including high-technology products were proposed for neurosurgical interventions. The sponge, having characteristics of deformability and resistance to compression, might be an alternative retractor for the neurosurgical era. Methods: Sponge obtainable from the ordinary market was broken into pieces and sterilized by ethylene oxide. During intervention, the appropriate sponge pieces were applied inside the dissected sulci for the purpose of retraction. Results: The sponge pieces were easily applied and supplied optimal retraction during operations. Proximal application to the dissected sylvian fissure enabled the exposure of the inner distal part including the insular surface, whereas application between the frontobasal surface and the orbital roof provided satisfactory exposure of the suprachiasmatic area. The retraction capacity of the sponge was less than that of self-retaining Leyla retractors, but the postoperative appearance of cortical surfaces was fine without any bruising or hyperemia. Conclusion: The sponge material, with its inner mechanical characteristics and ease of application like cotton pads, seems to be an alternative retractor in neurosurgical interventions, and these characteristic may inspire development of new high-technology retractors. (c) 2007 Elsevier Inc. All rights reserved.