Casting and Splinting

Frosch, Donald; Knott, Patrick

doi:10.1016/b978-1-4160-3001-0.50025-3

Cited by 1 publication

(1 citation statement)

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“…This outcome is logical because a proper technique dictates that using the vertical “in-and-out” sawing motion, alternating between firm pressure and relaxation followed by complete withdrawal of the blade minimizes heat generated by the cast saw. 24 With the smallest increase in saw blade temperature, a wait time of at least 7 minutes, using segmented cuts provided the safest conditions for cast saw use and will likely aid in avoiding thermal injury.…”

Section: Discussionmentioning

confidence: 99%

Having Patience With Our Patients: A Key Technique in Cast Saw Burn Prevention

Weisberg

Vingan

Gordon

et al. 2022

J Am Acad Orthop Surg

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Introduction: Although regarded as conservative treatment, casting is not without risk. Injuries may be sustained during application, during cast valving, through the immobilization process, or during cast removal. We developed an experimental model to investigate safe parameters for the appropriate length of time between fiberglass cast application and bivalving for cast saw use. Methods: A hospital sheet was rolled into a mock "arm" on which short-arm fiberglass casts were formed. An appropriate cast saw technique was used with complete withdrawal of the saw blade from the cast material between cuts. A total of 10 casts were made for control/no vacuum (N = 5) and study/vacuum (N = 5) groups. The temperature of the saw blade was measured at 1-minute increments beginning at 3 minutes after fiberglass submersion in water. A mixed factor analysis of variance assessed differences in temperature change over time between groups with a statistical threshold of P , 0.05. Results: Casts that set for 7 minutes were associated with lower blade temperatures compared with casts that set for 3, 4, 5, and 6 minutes. The average temperature increases for the 3-to 7-minute set times without the use of vacuum were 10.08 (6 1.42), 9.38 (61.31), 9.32 (61.85), 8.54 (62.10), and 5.62°F (62.42), respectively, and with the use of vacuum, they were 9. 40 (61.14), 8.36 (61.64), 7.84 (62.05), 7.30 (63.14), and 4.82°F (62.59), respectively. Independent of vacuum use, the change in temperature was significantly different from the maximum temperature (3 minutes) beginning at 7 minutes (all P , 0.043). Discussion: A minimum of 7 minutes of set time for a fiberglass cast before attempting to bivalve using segmented cuts is associated with the smallest increase in temperature of the saw blade. Blade temperature was not affected with the vacuum enabled. Clinicians can demonstrate best practices to minimize the risk of cast saw injuries.

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Section: Discussionmentioning

confidence: 99%