Gossypiboma after mandibular contouring surgery.
BACKGROUND
Gossypiboma is derived from the Latin word gossypium, meaning cotton, and it means a postoperatively retained foreign body used in operations. Several cases of gossypiboma have been reported especially after abdominal surgery, but there has not been any reported case in plastic surgery. Mandibular contouring surgery cannot ensure a view wide enough to avoid injury to surrounding structures such as a facial artery and a retromandibular vein. In addition, many surgeons pack the sponge into the operative field to prevent bleeding, and surgeons may neglect remnant surgical materials. Recognition of gossypiboma is essential but is often considerably delayed and cause medicolegal problems. Therefore, it is important to ensure that every effort is made to prevent such occurrences. We had a chance to evaluate and treat gossypiboma, and in this paper, we want to share our experiences.


METHODS
In circa 1999 to 2007, there were 3 cases diagnosed as gossypiboma after a mandible angle surgery. All patients were female, and some had signs of fever, swelling, tenderness, and purulent discharge of an oral wound. We performed a computed tomographic scan and blood test, and foreign body removal was done under general anesthesia. Intraoperatively, the diagnosis of gossypiboma was confirmed.


RESULTS
All symptoms were reduced or subsided after surgery. It was noted that no postoperative infection remained.


CONCLUSIONS
Gossypiboma must be considered when fever, unilateral swelling, tenderness, or unhealed oral wound is sustained despite an antibiotics therapy and a drainage procedure after a mandible angle surgery. In that case, a computed tomographic scan can be recommended as an effective method for detection of gossypiboma.
Song
Seung Yong
SY
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemoon-Gu, Seoul, Republic of Korea.
Hong
Jong Won
JW
Yoo
Won Min
WM
Tark
Kwan Chul
KC
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D003475:Curettage; D004487:Edema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005547:Foreign Bodies / Q000209:etiology*; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D013492:Suppuration; D015503:Surgical Sponges / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine