Cast Saw Burns

Puddy, A.; Sunkin, Jon A; Aden, James K; Walick, Kristina S.; Hsu, Joseph R.

doi:10.1097/bpo.0000000000000274

Cited by 22 publications

(28 citation statements)

References 5 publications

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“…Complications can occur during application, during cast valving, through the duration of immobilization, and during the removal process. [4][5][6][7][8][9][10][11][12][13] The technique of cast valving is done to alleviate excess pressure within a cast. 1,12,14 Typically, casts are valved or are fully removed with an oscillating cast saw, which is designed to cut through either plaster or fiberglass but spare the softer padding material and skin beneath.…”

mentioning

confidence: 99%

“…1,4,7,[10][11][12][13]15 There have been a variety of studies published in the literature evaluating cast saw injuries and factors to reduce their risk of occurrence. 2,4,[7][8][9][10][11][15][16][17][18][19][20][21][22][23] In a study from 1998, Ansari et al 4 found a 0.72% incidence rate of abrasions or burns related to removal of cast materials with a cast saw. Separately, Abu-Ghanem et al examined the variation in safety distance caused by different limb positions to find safe positions for patients during cast removal.…”

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confidence: 99%

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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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confidence: 99%

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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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“…The Stryker vacuum cast saw (model 93040: Stryker, Kalamazoo, MI) has been shown in multiple studies to maintain lower blade temperatures and show less temperature variability. 1,9,12 Vacuum cast saws are strongly recommended for all cast removals because of their proven thermal characteristics.…”

Section: Equipment Risk Factorsmentioning

confidence: 99%

“…1,2,7,29 Cooling time is shortened to 15 seconds when using a vacuum and 5 seconds with the addition of water or alcohol dips. 7,12,29…”

Section: Technique Risk Factorsmentioning

confidence: 99%

Cast Saw Burn Prevention: An Evidence-Based Review

Larson

Nicolay

2021

J Am Acad Orthop Surg

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Cast saw burns are an avoidable complication of cast removal and cast splitting. These iatrogenic injuries often lead to unacceptable clinical sequalae with significant financial and legal consequences. Therefore, a considerable body of research has been directed toward cast saw burn prevention. This review of currently published data provides clinicians with a summary of the literature to guide practice based on the best available evidence, with the goal of preventing iatrogenic cast saw burns. The PubMed database was queried for articles published from 1980 until present with the following key words: cast saw burns, cast saw blades, cast saws, orthopaedic education or surgical simulation. Relevant articles were reviewed and summarized. The prevention of cast saw burns involves awareness of clinical risk factors, maintenance of equipment, use of the proper technique, and the education of novice providers. By implementing evidence-based methods, orthopaedic surgeons and associated healthcare providers can aim to eliminate these preventable complications from their practice.

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“…Several articles on cast saw complications have emphasized the importance of the user’s experience[ 2 , 3 , 7 , 32 ]. Just like any new procedure, it has been studied that an inexperienced user can cause significant harm to the child if not done correctly.…”

Section: Cast Removalmentioning

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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Cast Saw Burns

Abstract: Provide simple method for decreasing risk of thermal injury when removing casts.

Cited by 22 publications

References 5 publications

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

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

Cast Saw Burn Prevention: An Evidence-Based Review

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

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