When are sponges, sutures, and instruments typically counted in the surgical setting?

In the surgical setting, counting sponges, sutures, and instruments is a critical step that typically occurs prior to the beginning of the surgical procedure. This initial count is essential for ensuring that all items are accounted for before the incision is made. It helps prevent any items from being left inside the patient, which could lead to complications such as infection or obstruction.

This practice is part of the standard safety protocols in surgery, often referred to as a "safety checklist" or "counts" to ensure that the surgical team has everything they need and nothing is inadvertently misplaced. Conducting this count before the procedure allows time to address any discrepancies and ensures that the surgical team can proceed with confidence.

The timing of when these counts are performed is crucial; they should not be conducted after the procedure has begun, as that could compromise the patient's safety. Similarly, counting after the patient is transported to the recovery room would be too late to rectify any potential issues. Counting during the closure of the surgical site is also insufficient to prevent problems, as it does not allow for immediate corrective actions if items are found to be missing.