The Prevention of Skin Excoriation Under Childrenʼs Hip Spica Casts Using the Goretex Pantaloon

Wolff, Craig; James, Preston

doi:10.1097/01241398-199505000-00024

Cited by 35 publications

(31 citation statements)

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“…Wolff et al found the incidence of unscheduled cast changes was 14% in the non-waterproof group versus 2.9% in the waterproof group in their study of hip spica casts. 9 Similarly, Hadley et al found that 33% of cotton casts required an unscheduled change without a major adverse reaction (defined as a necessary re-reduction or operative fixation) versus only a 10% unscheduled cast change rate with the Gore-Tex casts. 2 The results in this study are again in line with previous studies on older waterproof technology, with only 5% (1/20) unscheduled cast changes in the non-waterproof group versus 0% in the waterproof.…”

Section: Discussionmentioning

confidence: 98%

A Prospective Randomized Crossover Study on the Comparison of Cotton Versus Waterproof Cast Liners

Guillen

Fuller

Riedel

et al. 2016

Hand (New York, N,Y.)

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Background: Many fractures are treated with casting which can cause complications likely from inability to wash the extremity. Gore-Tex-based waterproof cast liner has been compared with cotton liner and shown to be superior in physician and patient scoring but also has high cost and difficult application. The purpose of this study is to compare newer generation waterproof liners with traditional cotton liner. It is the first study to compare this new waterproof liner and cotton liner in a crossover model, allowing patients to swim in the pool with the cast. Methods: Twenty patients (ages 3-30) with upper extremity injuries were randomized to waterproof-liner or cotton-liner casts made of fiberglass. Patients would switch cast liners halfway between their treatments to fulfill crossover criteria. All fractures were within a 2-week period from original incident. At each clinic visit, patients evaluated comfort parameters through questionnaires, and physicians rated skin condition. Patients were also asked which cast liner they preferred at the end of the study. Results: There were no unscheduled cast changes. The waterproof-liner group had better scores for odor (P = .041), sweat (P = .016), and overall physician-rated score (P = .038). There was no significant difference in other patient-rated parameters. Seventy-five percent of patients preferred waterproof casting to the cotton liner. Conclusions: This new waterproof cast liner, compared with cotton cast liner, had better odor, sweat, and overall physician scores. The waterproof liners allow patients to rinse casts daily, and the majority of patients prefer waterproof to cotton liner.

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Section: Discussionmentioning

confidence: 98%

A Prospective Randomized Crossover Study on the Comparison of Cotton Versus Waterproof Cast Liners

Guillen

Fuller

Riedel

et al. 2016

Hand (New York, N,Y.)

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“…Other researchers have discovered the bene®t of breathable materials in preventing urine-induced dermatitis. Wol and James (9) showed that excoriation of children's skin caused by urine leakage underneath a full pelvic cast could be eliminated by a breathable Goretex pantaloon worn underneath the cast. A small subset of infants experienced dermatitis that did not improve with the use of breathable diapers.…”

Section: Discussionmentioning

confidence: 99%

“…“Breathable” Goretex materials incorporated into sportswear allow these garments to be comfortable, yet waterproof. Breathable underliners have been shown to reduce dermatitis under casts (9). Previously we showed that placement of a microporous film within the diaper cover significantly reduced both RH and skin hydration (8).…”

mentioning

confidence: 99%

Effects of Breathable Disposable Diapers: Reduced Prevalence of Candida and Common Diaper Dermatitis

Akin

Spraker

Aly

et al. 2001

Pediatric Dermatology

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Infants wearing breathable disposable diapers experienced significantly less diaper dermatitis (DD) compared to infants wearing standard, nonbreathable disposable diapers in a series of double-blind clinical trials. Severe DD, including confirmed infection with Candida albicans, was reduced by 38-50% among infants wearing highly breathable (HB) diapers. The prevalence of DD was inversely related to the breathability of the garments. The inhibitory effect of breathable diapers on the survival of Candida was further confirmed in controlled experiments with adult volunteers. A suspension of C. albicans cells was applied to delineated sites on the volar forearm. Each site was then covered by a full-thickness patch from either an HB or a standard diaper. Survival of Candida colonies was reduced by almost two-thirds in the breathable diaper-covered sites compared to the control sites.

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“…Cast application entails many elements which include the type and amount of material used, type of soft roll, presence or absence of stockinet and the method of rolling the cast as well as the final cast shape and position. The importance of a well-molded cast cannot be over emphasized[ 12 , 20 ]. One of the main tenets of the cast application is to apply a mold based on the fracture pattern to, when applicable, maintain reduction and/or prevent displacement from occurring or at least worsening (Figure 1 ).…”

Section: Cast Applicationmentioning

confidence: 99%

“…Numerous studies, historical and recent, have looked at common complications of casting[ 1 - 11 ]. Many of these have focused on hip spica casts and forearm fractures treated with short or long arm casts[ 12 - 16 ]. These complications can range from skin excoriations to compartment syndrome.…”

Section: Introductionmentioning

confidence: 99%

Casting: Pearls and pitfalls learned while caring for children’s fractures

Nguyen¹,

McDowell²,

Schlechter³

2016

WJO

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Casting is a routine procedure used for fracture care in the pediatric population. The purpose of this review is to provide pearls and pitfalls that our institution has learned from previous literature. When applying the cast, we recommend using cotton padding for the liner and fiberglass or plaster depending on how much swelling is expected. A well-molded cast must be applied in order to prevent further fracture displacement. Cast valving is a valuable technique that allows a decrease in pressure which prevents discomfort and complications like compartment syndrome. Preventing thermal injuries, skin complications, and a wet cast are other important considerations when caring for casts. Appropriate use of a cast saw, avoiding pressure spots, and properly covering the cast are ways to respectively prevent those complications. Lastly, patient education remains one of the most valuable tools in ensuring proper cast maintenance.

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The Prevention of Skin Excoriation Under Childrenʼs Hip Spica Casts Using the Goretex Pantaloon

Cited by 35 publications

References 0 publications

A Prospective Randomized Crossover Study on the Comparison of Cotton Versus Waterproof Cast Liners

A Prospective Randomized Crossover Study on the Comparison of Cotton Versus Waterproof Cast Liners

Effects of Breathable Disposable Diapers: Reduced Prevalence of Candida and Common Diaper Dermatitis

Casting: Pearls and pitfalls learned while caring for children’s fractures

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