Impact of Casting and Splinting Manipulations on Below-Dressing Pressures: An Experimental Model

Adapa, Nikhil; Goyal, Kanu S.

doi:10.1177/1558944718799391

Cited by 2 publications

(6 citation statements)

References 10 publications

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“…Acute compartment syndrome is a limb-threatening emergency that occurs most often after fracture [ 11 ] and cast application [ 12 , 13 ]. Clinical findings such as severe pain, weak pulse, reduced mobility, numbness, or pallor of the affected limb have low sensitivity (13%–64%) compared with ICP monitoring (94%) for diagnosing acute compartment syndrome, and they can be absent in some cases [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Technique to Monitor the Pressure under a Cast: A Mobile Application-Friendly Bluetooth Pressure Sensor

Mahiroğulları

Sürücü

Çerci

et al. 2022

International Journal of Clinical Practice

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Aim. The purpose of this study was to design a sensor that could monitor the skin-cast contact surface pressure (SCCSP) of a limb under a cast and inform the user via a mobile application when the pressure increases. Methods. In this experimental study, an infant sphygmomanometer cuff was initially placed on the forearm of 10 volunteers. A pressure sensor with a Bluetooth chip was then placed on the volar aspect of the forearm. Short arm plaster was applied with synthetic cast material. The SCCSP under the plaster was measured by the sensor and the measured values were transmitted to a mobile application via a Bluetooth chip. The mobile application processed the data from the chip and converted it to mmHg. Results. Intracompartmental pressure (ICP) values were categorized as 0, 10, 20, 30, 40, 50, 60, and 75 mmHg. The highest SCCSP was 75 mmHg CP, while the lowest was 0 mmHg CP. The correlation coefficient of the mean pressure values was 0.993 ( p ≤ 0.001 ) (SD 0.002, range 0.989–0.997), and there was a significant relationship between ICP and SCCSP values ( p ≤ 0.05 ). Conclusion. We can monitor SCCSP, detect limb swelling, and notify the user via a mobile application by using Bluetooth pressure sensors.

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Section: Discussionmentioning

confidence: 99%

Noninvasive Technique to Monitor the Pressure under a Cast: A Mobile Application-Friendly Bluetooth Pressure Sensor

Mahiroğulları

Sürücü

Çerci

et al. 2022

International Journal of Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Numerous studies have compared the safety profiles of splints and casts with various modifications applied. Adapa and Goyal 2 compared the pressure underlying a splint with an elastic bandage applied loosely, medium, and tight. They found significant pressure differences between these 3 groups and with simulated swelling of 30 mL, a 6-fold pressure difference between the loose and tight groups.…”

Section: Discussionmentioning

confidence: 99%

“…An experimental model previously described by Adapa and Goyal 2 was used (Figure 1). Splints were applied to a 3-inch poly-vinyl chloride (PVC) pipe with a 100 mL bag of saline secured to it.…”

Section: Methodsmentioning

confidence: 99%

“…Splitting a cast, splint, or the underlying padding can significantly decrease pressure on the extremity. [2][3][4][5][6][7][8][9] The tension with which an elastic bandage is applied over a splint can significantly affect the pressure on the underlying forearm. 2 Many surgeons have advocated for the use of a bias cut stockinette instead of an elastic bandage (commonly referred by the brand name "ACE" wrap) to reduce the risk of pressure-related complications.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9] The tension with which an elastic bandage is applied over a splint can significantly affect the pressure on the underlying forearm. 2 Many surgeons have advocated for the use of a bias cut stockinette instead of an elastic bandage (commonly referred by the brand name "ACE" wrap) to reduce the risk of pressure-related complications. However, no study has assessed the impact of this variable or the validity of this theory.…”

Section: Introductionmentioning

confidence: 99%

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Extremity Pressure in Splints Wrapped With an Elastic Bandage Versus Bias Cut Stockinette: An Experimental Model

Schoenfeldt

Bowman

MacConnell

et al. 2022

Hand (New York, N,Y.)

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Background: Many variables affect the pressure caused by splinting or casting. The purpose of this study was to compare pressure underlying a splint wrapped with either an elastic bandage or a bias cut stockinette. Methods: Thirty-two plaster volar resting splints were applied to a simulated extremity with a saline bag secured to it. A pressure transducer was connected to the saline bag to monitor changes in pressure once splints were applied, and 15 mL increments of saline were added to the bag to simulate swelling. Each dressing type was tested with normal application and tight application. Results: Normal application splints wrapped with either bias cut stockinette or an elastic bandage demonstrated similar initial splint pressures ( P = .81). With simulated swelling, splints wrapped with bias cut stockinette demonstrated a 15 mmHg (95% confidence interval [CI], 1.5-28.5) higher average pressure than those wrapped with an elastic bandage ( P = .035). Tight application splints with an elastic bandage wrap demonstrated a 46 mmHg (95% CI, 16-77) higher initial splint pressure than those wrapped with bias cut stockinette ( P = .009). Conclusions: Splints wrapped using either an elastic bandage or bias cut stockinette appear to have a similar safety profile, although in cases of excessive swelling, an elastic bandage may provide additional compliance. Tight splint application appears to be more hazardous with the use of an elastic bandage compared with a bias cut stockinette. Further study of the use of elastic bandages and bias cut stockinettes in the clinical setting may be warranted.

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Impact of Casting and Splinting Manipulations on Below-Dressing Pressures: An Experimental Model

Abstract: Splitting a dressing, utilizing synthetic cotton padding, and applying an elastic bandage cautiously can help reduce surface pressures and allow the construct to be more accommodating to soft tissue swelling.

Cited by 2 publications

References 10 publications

Noninvasive Technique to Monitor the Pressure under a Cast: A Mobile Application-Friendly Bluetooth Pressure Sensor

Noninvasive Technique to Monitor the Pressure under a Cast: A Mobile Application-Friendly Bluetooth Pressure Sensor

Extremity Pressure in Splints Wrapped With an Elastic Bandage Versus Bias Cut Stockinette: An Experimental Model

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