Factors contributing to the temperature beneath plaster or fiberglass cast material

Hutchinson, Michael J.; Hutchinson, Mark R.

doi:10.1186/1749-799x-3-10

Cited by 28 publications

(40 citation statements)

References 8 publications

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“…Certain situations and surgeries bring additional challenges to regional anesthesia, such as thermal cast placement applied to a blocked extremity. Cast application techniques are known to prevent burn injuries4,6 but, as with any procedure, mistakes still occur. Internal temperatures can reach >50°C with a fast curing plaster cast, and it has been found that >49°C is enough to cause significant burn injuries 6.…”

Section: Discussionmentioning

confidence: 99%

Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

Boyle

Badal²,

Boeve³

2011

LRA

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Although regional anesthesia offers advantages for intraoperative and postoperative pain relief, it is not possible without complications. A case of a significant burn injury after splint placement is described after a peripheral nerve block was performed for postoperative pain management. It is our hope that this case alerts physicians and others involved in the management of postoperative patients to the challenges of managing a blocked extremity after thermal cast placement and offers solutions that can be standardized.

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Section: Discussionmentioning

confidence: 99%

Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

Boyle

Badal²,

Boeve³

2011

LRA

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“…The next day, it was noted that the patient sustained a 3.5 Â 4-cm superficial partial thickness burn on the proximal volar forearm, corresponding precisely to an area where the plaster was doubled-over so that the thickness of plaster was 24 sheets instead of 12 that generated substantial amount of heat to cause the burn. 13 When the resident who placed the splint discovered that the patient had been harmed because of his error, he confessed that he was responsible for the injury, apologized, debrided and dressed the wound, and notified the Office of Clinical Safety (OCS) (formerly known as Risk Management). A representative from the OCS contacted the patient and her family and assured them that the circumstances surrounding the incident were being reviewed and that any costs associated with the burn would not be charged to the patient.…”

Section: Casementioning

confidence: 99%

Discussing Harm-Causing Errors With Patients

Vercler

Buchman

Chung

2015

Annals of Plastic Surgery

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Plastic surgery is a field that demands perfection, yet despite our best efforts errors occur every day. Most errors are minor, but occasionally patients are harmed by our mistakes. Although there is a strong ethical requirement for full disclosure of medical errors, data suggest that surgeons have a difficult time disclosing errors and apologizing. "Conventional wisdom" has been to avoid frank discussion of errors with patients. This concept is fueled by the fear of litigation and the notion that any expression of apology leads to malpractice suits. Recently, there has been an increase in the literature pointing to the inadequacy of this approach. Policies that require disclosure of harm-causing medical errors to the patient and the family, apology, and an offer of compensation cultivate the transparency necessary for quality improvement efforts as well as the positive moral development of trainees. There is little published in the plastic surgery literature regarding error disclosure to provide guidance to practitioners. In this article, we will review the ethical, therapeutic, and practical issues involved in discussing the error with the patient and apologizing by presenting a representative case. This primer will provide an understanding of the definition of medical error, the ethical support of error disclosure, the barriers to disclosure, and how to overcome those barriers.

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“…[30] Thermal exposure over 40°C for an extended period of time may cause thermal injury to skin and can cause burns. [28,31] Thermal conditions that cause skin burns are a function of the time and potentially the method of heat exposure as well as the skin temperature, and a skin temperature above 42°C should typically be avoided when studying heat effects. [32] Prolonged exposure of skin to 43°C or higher could lead to blister formation.…”

Section: Thermoregulation and Heat Effects On The Temperature Of Tmentioning

confidence: 99%

Heat effects on drug delivery across human skin

Hao

Ghosh

et al. 2016

Expert Opinion on Drug Delivery

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Introduction Exposure to heat can impact the clinical efficacy and/or safety of transdermal and topical drug products. Understanding these heat effects and designing meaningful in vitro and in vivo methods to study them are of significant value to the development and evaluation of drug products dosed to the skin. Areas covered This review provides an overview of the underlying mechanisms and the observed effects of heat on the skin and on transdermal/topical drug delivery, thermoregulation and heat tolerability. The designs of several in vitro and in vivo heat effect studies and their results are reviewed. Expert opinion There is substantial evidence that elevated temperature can increase transdermal/topical drug delivery. However, in vitro and in vivo methods reported in the literature to study heat effects of transdermal/topical drug products have utilized inconsistent study conditions, and in vitro models require better characterization. Appropriate study designs and controls remain to be identified, and further research is warranted to evaluate in vitro-in vivo correlations and the ability of in vitro models to predict in vivo effects. The physicochemical and pharmacological properties of the drug(s) and the drug product, as well as dermal clearance and heat gradients may require careful consideration.

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Factors contributing to the temperature beneath plaster or fiberglass cast material

Cited by 28 publications

References 8 publications

Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

Discussing Harm-Causing Errors With Patients

Heat effects on drug delivery across human skin

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