Project details:
In October 2025, NIHR asked Bristol ESG to undertake a systematic review to consider the effectiveness and cost-effectiveness of different interventions used to prevent retained items following an invasive procedure.
The review is funded by the NIHR Evidence Synthesis Programme (project number: NIHR177587) and is registered with PROSPERO (CRD420251184603).
Project status: ongoing
Contact: bristol-esg@bristol.ac.uk
What is the problem?
During surgery, or other medical procedures that involve a cut to the skin, or where devices are used inside a person’s body (such as fitting a pacemaker or stent), the healthcare team use large amounts of equipment. Many of these items, like gauze swabs, sponges, guidewires and drill bits, are small enough to become lost during a procedure. Very rarely, items may accidentally be left inside the patient’s body.
To avoid items being lost, the healthcare team uses a careful counting process. All items used are written down and then counted by at least two people, to make sure that nothing is left behind. This means that any missing items are spotted and can be found before the end of the procedure.
However, items are still occasionally left behind, despite this counting technique. When an item is left inside someone’s body, it can cause serious problems such as pain, organ damage or infection, and it needs to be removed. Often this means that the person must go back to hospital and they may need another operation.
What are we trying to find out?
We are trying to find out whether there are better ways to keep track of used items during surgery and medical procedures, to reduce the risk of anything being left inside someone’s body. We will look at new ways of keeping track of items, including the use of modern technologies (such as barcode scanners – similar to those used to scan your shopping), to see whether these help healthcare professionals to better monitor the position of equipment, and mean that fewer items are left inside people’s bodies.
How will we do this?
We will carry out a systematic review of the evidence. A systematic review involves searching for and summarizing the evidence from all the existing studies on a research topic, to try and make sense of their findings. We will look for all the studies that have used new methods to keep track of items during procedures, and collect information about whether these methods worked.
What difference will it make?
We hope to find out which methods help prevent items being left inside people’s bodies after procedures. This should help healthcare providers decide how they should keep track of equipment and reduce the chance of items being left inside a patient.
