Submandibular cellulitis thought to be caused by retained gauze: A case report

We report a case of submandibular cellulitis caused by retained gauze.The patient was a 29-yearold woman who had undergone a genioplasty and bilateral mandibular angloplasty under general anesthesia at another hospital.She presented to our department on the 17th day of her illness because of postoperative swelling of the right-sided submental area.After various imaging examinations, intraoral incisional drainage and anti-inf lammatory surgery was performed.The patient underwent outpatient local cleansing and intravenous antibacterial therapy, however the symptom showed a tendency to flare up again.On the 29th day, under a diagnosis of right-sided submandibular cellulitis and suspected gas gangrene, intraoral and extraoral incisional draining and anti-inflammatory surgery were performed under general anesthesia, and retained gauze was found in the right-sided masseter muscle gap.The gauze was removed and antibacterial agents were administered continuously, and the patient was discharged from the hospital on the 38th day.Although there are various possible causes of retained gauze, it is necessary for multiple persons to count gauze multiple times during surgery to confirm that it has been collected without fail.There have been reports of cases in which retained gauze occurs even after manual counting.The digital counting system currently being introduced may contribute to the prevention of retained gauze by using it in combination with conventional manual counting.