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An Incremental Step in Patient Safety: Reducing the Risks of Retained Foreign Bodies by the Use of an Integrated Laparotomy Pad/Retractor

Department of Surgery, Divisions of Colorectal and Upper GI Surgery, Beth Israel Medical Center, New York, New York, wenker{at}chpnet.org

Joseph E. Martz, MD

Department of Surgery, Divisions of Colorectal and Upper GI Surgery, Beth Israel Medical Center, New York, New York

Antonio Picon, MD

Department of Surgery, Divisions of Colorectal and Upper GI Surgery, Beth Israel Medical Center, New York, New York

Steven D. Wexner, MD

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida

James W. Fleshman, Jr, MD

Colon and Rectal Surgery, Washington University School of Medicine, St. Louis, Missouri

John Koulos, MD

Department of Obstetrics and Gynecology (Gynecologic Oncology), Beth Israel Medical Center, New York, New York

Noah Goldman, MD

Department of Obstetrics and Gynecology (Gynecologic Oncology), Beth Israel Medical Center, New York, New York

Retained foreign body is a recognized complication of abdominal, pelvic, and thoracic surgery and a cause of medical malpractice. Efforts to reduce its incidence include safe exposure and the use of fewer laparotomy pads. The EZ DASH is an absorbent 12-thickness laparotomy pad covering a malleable stainless steel mesh, providing both the needed retraction and a reduction in the use of individual pads. EZ DASH has been introduced into clinical use in 183 consecutive cases by specialty surgeons (colorectal, gynecology, and gynecologic oncology services) at multiple medical centers. The retractor may be shaped to the individual needs of an operating field, eg, the pelvis, and the small bowel secured behind the retractor, held in place by the tension of its mesh and the security of the abdominal wall. Positioning has been intuitive and secure, and the intraoperative use of sponges and of operating time have both been noticeably reduced. Among 183 cases, 91% of uses were felt to reduce OR time by 5 to 10 minutes. Ninety-three percent of EZ DASH cases used fewer individual laparotomy pads for small bowel retraction. Ninety-five percent of uses suggested a value added to the case by the operating surgeon with an expressed desire to use the product repeatedly. The EZ DASH is a simple method of obtaining small bowel retraction and laparotomy pad absorption with a reduction in the need for individual pads, providing excellent exposure for the operative field and reducing the risk of retained foreign body.

Key Words: patient safety • retractor • absorbent lap pad • foreign body retention

This version was published on September 1, 2008

Surgical Innovation, Vol. 15, No. 3, 203-207 (2008)
DOI: 10.1177/1553350608321105


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