Are we swab fritters?

Abstract

Introduction: Gauze towels and swabs help to keep the surgical field clear of blood and fluid facilitating safe surgery. Ensuring the supply of sterile gauze to operating theatres is both costly and a logistical burden, hence wastage should be kept to a minimum. This study sought to evaluate the utilization and wastage of gauze towels and swabs during elective minor surgery. Methods: This was a prospective descriptive study conducted from December 2019 to May 2020 in a general surgical theatre of a tertiary hospital. Utilization of towels and swabs was observed for the following procedures: inguinal hernia repair (IHR), paraumbilical hernia repair (PUHR), Jaboulay’s procedure (JP) and carpal tunnel decompression (CTD). The pre and postoperative towel and swab counts were documented for each procedure. Results: A total of 64 procedures were observed. This included IHRs 40.6% (n=26), PUHRs 31.3% (n=20) and JPs / CTDs 28.1% (n=18). The number of gauze towels and swabs issued pre- operatively were 194 and 839 respectively. Utilisation of gauze towels and swabs was 84.02% (n=163) and 71.51% (n=600) respectively. Non-usage of gauze swabs was 29.2% (n=110) for IHRs, 35.7% (n=91) for PUHRs and 18.3% (n=38) for JPs and CTDs. Conclusion: Significant quantities of gauze towels and swabs, up to a third of those taken, were not used in minor elective procedures. The level of blood soakage of individual swabs and towels was not assessed nor was wastage during major elective surgery. The cost and logistical implications of this wastage and strategies to streamline usage require study.