When is the final instrument count completed during a surgical procedure?

The final instrument count is a critical safety measure performed to ensure that all surgical instruments are accounted for before the procedure is fully complete. This count typically takes place when the surgeon closes the subcutaneous layers. At this point, it is imperative to confirm that no instruments or other materials are left inside the patient's body, as this can lead to serious complications post-surgery. This phase generally signifies that the majority of the surgical work has been conducted, making it a logical and crucial moment to carry out this final check.

Completing the instrument count at this stage allows the surgical team to focus on the final layers of closure, ensuring that the integrity of the surgical site is maintained and reducing the risk of retained foreign objects, which can occur if the count is not diligently performed. Making sure the instruments are accounted for at this time helps in reducing the possibility of needing to reopen the site later if an item is found missing, thereby improving patient safety and outcomes.