What constitutes an accurate sponge count, and how many counts are required?

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Sponge counting is a safety check to prevent leaving a sponge inside the patient. The best approach is to count by type and quantity with two team members verifying the count. Perform the count before the incision to establish what is in the field, and again before wound closure to confirm nothing was left behind. If sponges or other counted items are added during the procedure, a third count is done to include those new items. This double-check system provides redundancy and reduces the chance of a retained item. Counting by weight or counting by number alone isn’t reliable, and a single count lacks the necessary verification. Counts are a routine part of the flow, not just something done when a loss is suspected.