Identifying lost surgical needles with visible and near infrared fluorescent light emitting microscale coating

Ward, Erin; Yang, Jian; DeLong, Jonathan C.; Sung, Tsai-Wen; Wang, James; Barback, Chris; Mendez, Natalie; Horgan, Santiago; Trogler, William C.; Kummel, Andrew C.; Blair, Sarah L.

doi:10.1016/j.surg.2017.10.025

Cited by 5 publications

(9 citation statements)

References 26 publications

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“…Indocyanine green (ICG) is one of the NIR fluorophores approved by the United States Food and Drug Administration (FDA) for some clinical use [49]. ICG is frequently used in imaging [54] and surgical applications [55][56][57], and was recently proposed in the development of NIRfluorescent coatings on medical devices [58].…”

Section: Introductionmentioning

confidence: 99%

“…Third, retained foreign objects (RFO) after surgery is a serious complication [62], which sometimes requires emergency open surgery [62]. Fluorescent coatings on surgical instruments could help to minimize such errors [58]. Most of the existing coating materials are composed of either ICG or other visible/blue light excitable fluorophores [27,58].…”

Section: Introductionmentioning

confidence: 99%

“…Fluorescent coatings on surgical instruments could help to minimize such errors [58]. Most of the existing coating materials are composed of either ICG or other visible/blue light excitable fluorophores [27,58]. Coating materials based on ICG suffer from limited brightness and poor photostability, whereas those composed of visible/blue fluorophores show low penetration depth and are not compatible with well-established commercially available laparoscopic systems [58].…”

Section: Introductionmentioning

confidence: 99%

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Near-infrared fluorescent coatings of medical devices for image-guided surgery

et al. 2020

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Rapidly expanding field of image-guided surgery needs new materials for near-infrared imaging with deep tissue penetration. Here, we introduce near-infrared coating of equipment (NICE) for image-guided surgery based on a series of lipophilic cyanine-7.5 dyes with bulky hydrophobic counterions and a biocompatible polymer, poly(methyl methacrylate). The NICE material exhibits superior brightness (15-20-fold higher) and photostability compared to fluorescent coatings based on commonly used indocyanine green (ICG). It can be deposited on different surfaces and devices, such as steel and gold fiducials, silicone and PVC catheters, polymeric surgical sutures and gauzes. Such coated medical devices show excellent stability in air and buffer for 150 days. Accelerated ageing revealed their shelf-life of 3 years. They are also stable in serum-containing media, whereas ICG-based coating shows rapid dye leakage. NICE is compatible with standard sterilization protocols based on ethylene oxide and vapor. Moreover, our coating material is biocompatible, where cultured cells spread effectively without signs of cytotoxicity. Ex vivo studies suggest that NICE on fiducials can be visualized as deep as 0.5 cm, and NICE on catheters enables their visualization inside ureters and esophagus. Finally, NICE on different medical devices has been validated for image-guided surgery in porcine and human cadaver models. Thus, the developed NIR coating material emerges as a powerful tool for a variety of medical applications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Near-infrared fluorescent coatings of medical devices for image-guided surgery

et al. 2020

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“…Quick and cheap [32,42] Low radiation dose [32,42] CT does not appear to be superior to intraoperative X-ray [4] False negative rate increases as needle size becomes smaller [23,43] needles smaller than 13 mm are not detectable [22,34,44] Dependent on radiologist's knowledge of the lost needle and its last location [23,45] Development of standard policy of indications for radiography Education for all members of the team to improve communication between radiology and surgical team [31] Computer-aided Detection (CAD)…”

Section: Radiographymentioning

confidence: 99%

“…RSI 100 times more likely if there is a count discrepancy [17] When combined with technological advancements, this can improve its accuracy [44,45] RSI can still occur with a correct count [39] Quiet OR and reduce multi-tasking during count [37,42] Change focus of count to RSI prevention rather than checklist [42] Intraoperative Radiography…”

Section: Manual Countingmentioning

confidence: 99%

Risk factors and preventive strategies for unintentionally retained surgical sharps: a systematic review

et al. 2021

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Background A retained surgical item (RSI) is defined as a never-event and can have drastic consequences on patient, provider, and hospital. However, despite increased efforts, RSI events remain the number one sentinel event each year. Hard foreign bodies (e.g. surgical sharps) have experienced a relative increase in total RSI events over the past decade. Despite this, there is a lack of literature directed towards this category of RSI event. Here we provide a systematic review that focuses on hard RSIs and their unique challenges, impact, and strategies for prevention and management. Methods Multiple systematic reviews on hard RSI events were performed and reported using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Database searches were limited to the last 10 years and included surgical “sharps,” a term encompassing needles, blades, instruments, wires, and fragments. Separate systematic review was performed for each subset of “sharps”. Reviewers applied reciprocal synthesis and refutational synthesis to summarize the evidence and create a qualitative overview. Results Increased vigilance and improved counting are not enough to eliminate hard RSI events. The accurate reporting of all RSI events and near miss events is a critical step in determining ways to prevent RSI events. The implementation of new technologies, such as barcode or RFID labelling, has been shown to improve patient safety, patient outcomes, and to reduce costs associated with retained soft items, while magnetic retrieval devices, sharp detectors and computer-assisted detection systems appear to be promising tools for increasing the success of metallic RSI recovery. Conclusion The entire healthcare system is negatively impacted by a RSI event. A proactive multimodal approach that focuses on improving team communication and institutional support system, standardizing reports and implementing new technologies is the most effective way to improve the management and prevention of RSI events.

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Clinically Translatable Solid‐State Dye for NIR‐II Imaging of Medical Devices

Li,

Shi,

et al. 2023

Advanced Science

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Medical devices are commonly implanted underneath the skin, but how to real‐time noninvasively monitor their migration, integrity, and biodegradation in human body is still a formidable challenge. Here, the study demonstrates that benzyl violet 4B (BV‐4B), a main component in the FDA‐approved surgical suture, is found to produce fluorescence signal in the first near‐infrared window (NIR‐I, 700–900 nm) in polar solutions, whereas BV‐4B self‐assembles into highly crystalline aggregates upon a formation of ultrasmall nanodots and can emit strong fluorescence in the second near‐infrared window (NIR‐II, 1000–1700 nm) with a dramatic bathochromic shift in the absorption spectrum of ≈200 nm. Intriguingly, BV‐4B‐involved suture knots underneath the skin can be facilely monitored during the whole degradation process in vivo, and the rupture of the customized BV‐4B‐coated silicone catheter is noninvasively diagnosed by NIR‐II imaging. Furthermore, BV‐4B suspended in embolization glue achieves hybrid fluorescence‐guided surgery (hybrid FGS) for arteriovenous malformation. As a proof‐of‐concept study, the solid‐state BV‐4B is successfully used for NIR‐II imaging of surgical sutures in operations of patients. Overall, as a clinically translatable solid‐state dye, BV‐4B can be applied for in vivo monitoring the fate of medical devices by NIR‐II imaging.

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Identifying lost surgical needles with visible and near infrared fluorescent light emitting microscale coating

Cited by 5 publications

References 26 publications

Near-infrared fluorescent coatings of medical devices for image-guided surgery

Near-infrared fluorescent coatings of medical devices for image-guided surgery

Risk factors and preventive strategies for unintentionally retained surgical sharps: a systematic review

Clinically Translatable Solid‐State Dye for NIR‐II Imaging of Medical Devices

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