Intraoperative loss of surgical needle with 8–0 nylon: radiographic findings

Yanagawa, Taro; Harada, Yoichi; Yamashita, Keiichi; Hatayama, Toru

doi:10.1136/bcr-2018-227738

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…Yanagawa reported a case of retained 8-0 nylon in the brain of a 68-year-old woman. The patient subsequently underwent a MRI on postoperative day 1 that showed a metal artifact and the authors considered it unlikely that the needle had moved as a result of the MRI examination (Yanagawa et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of retained surgical items (RSI) is estimated to be one in every 1000–18,000 surgeries (Weprin, Crocerossa, et al, 2021). Institutions, including our own, enforce a retrieval protocol that utilizes intra‐operative x‐ray imaging to detect RSIs (Kieval et al, 2009; Macilquham et al, 2003; McCombe et al, 2021; Yanagawa et al, 2018). Our institution's protocol requires the operating surgeon to pause wound closure and proceed with close examination of the wound, whereas the operating room (OR) staff search the nonsterile field.…”

Section: Introductionmentioning

confidence: 99%

“…However, this study used nonhuman materials to assess x-ray efficacy. Yanagawa et al (2018) took a plain x-ray of the needles and reported difficulty to identify needles with 10-0 nylon in a plain radiograph, whereas those with 6-0 nylon were clearly detectable; again, however, this study lacks the use of human tissues to mimic a clinical scenario. Moreover, Kieval et al (2009) placed ophthalmologic 10-0 nylon suture needles into porcine eyes positioned within human skull.…”

mentioning

confidence: 96%

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Assessment of x‐ray efficacy for intraoperative microneedle retrieval using a cadaveric model

Chaker,

Hung,

Vinson

et al. 2024

Microsurgery

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IntroductionInstitutional protocols often mandate the use of x‐rays when a microneedle is lost intraoperatively. Although x‐rays can reliably show a macroneedle, the benefit of x‐rays in detecting microneedles in human tissues has not been established as available data on this topic are investigated in anthropometric models. The current study aims to evaluate whether x‐rays can reliably detect retained microneedles in a human cadaveric model. We hypothesize that microneedles would be detected at a significantly lower rate than macroneedles by x‐ray in human tissues.Materials and MethodsNeedles ranging from 4‐0 to 10‐0 were placed randomly throughout a cadaveric hand and foot. Each tissue sample was x‐rayed using a Fexitron X‐Ray machine, taking both anteroposterior and lateral views. A total of six x‐ray images were then evaluated by 11 radiologists, independently. The radiologists circled over the area where they visualized a needle. The accuracy of detecting macroneedles (size 4‐0 to 7‐0) was compared with that of microneedles (size 8‐0 to 10‐0) using a chi‐square test.ResultsThe overall detection rate for the microneedles was significantly lower than the detection rate for macroneedles (13.5% vs 88.8%, p < .01). When subcategorized between the hand and the foot, the detection rate for microneedles was also significantly lower than the rate for macroneedles (hand: 7.6% for microneedles, 93.2% for macroneedles, p < .01; foot: 19.5% for microneedles, 84.4% for macroneedles, p < .01). The detection rate, in general, significantly decreased as the sizes of needles became smaller (7‐0:70.5%, 8‐0:18.2%, 9‐0:16.7%, 10‐0:2.3%, p < .01).ConclusionX‐rays, while useful in detecting macroneedles, had a significantly lower rate of detecting microneedles in a cadaveric model. The routine use of x‐rays for a lost microneedle may not be beneficial. Further investigation with fresh tissue and similar intraoperative x‐ray systems is warranted to corroborate and support these findings.

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Section: Discussionmentioning

confidence: 99%