Which practice best supports preventing retained surgical items?

• A. Counting sponges and sharps before and after the procedure.
• B. Relying on memory for counts.
• C. Not performing counts to save time.
• D. Counts are optional if the team agrees.

Answer: (A)

Accurate counting of items is the primary safeguard against leaving something inside a patient. By tallying sponges and sharps at key times—before the incision and again before wound closure—the team creates a verifiable record that all items used are accounted for. This verification helps catch any discrepancies while the patient is still in the OR, which is far safer than relying on memory or assuming everything is fine.

Relying on memory is error-prone because distractions, emergencies, and multitasking can cause items to be misplaced or forgotten. Skipping counts or treating them as optional removes the safety net and increases the risk of retained surgical items, which can lead to serious harm, additional surgery, and legal consequences.

If a mismatch occurs, the standard response is to pause and re-count, re-check the instrument and sponge trays, search the wound if needed, and obtain imaging if the item isn’t found. This disciplined approach is a cornerstone of surgical safety.