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

Nguyen, Shawn; McDowell, Mitchell; Schlechter, John A.

doi:10.5312/wjo.v7.i9.539

Cited by 27 publications

(31 citation statements)

References 35 publications

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“…Patients with DRF treated with either of these casts are instructed to keep the cast dry to avoid structural damage and to prevent skin and odor problems associated with excess moisture. 2 , 3 Patients have reported that this places a burden on daily tasks such as showering, bathing, or hand washing. 4 A recent study on a pediatric population has shown that nearly 50% of unplanned cast changes can be attributed to casts getting wet, imposing a clinical and financial burden.…”

Section: Distal Radius Fracture Castsmentioning

confidence: 99%

Comparison of Water Absorption and Drying in Distal Radius Fracture Casts and Orthoses

White¹,

Wyk²

2021

JAAOS Glob Res Rev

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Introduction: Traditional plaster and fiberglass casts are not waterproof. This experimental study compares the water-resistant and drying properties of two commercially available orthoses with traditional cast liners. Methods: Two orthotic brace systems were selected for comparative waterproof testing with plaster and fiberglass traditional cast liners. This entailed water submersion for 10 seconds, followed by light drip drying for another 10 seconds. Moisture levels were then measured at four different locations immediately after drip drying and then every 15 minutes up to 45 minutes. Results: The Zero-Cast Wx orthosis retained the least moisture after initial immersion and was fully dry within 45 minutes. The Exos upper extremity brace also demonstrated a low initial mean moisture content but lost little moisture during drying. In comparison, both the cotton-lined plaster cast and Delta Dr. cast liner systems demonstrated the greatest amount of water absorbed and moisture retention. Discussion: Both orthotic brace systems demonstrated markedly less water absorption compared with the cotton-lined plaster cast and Delta Dr. cast liner systems. The Zero-Cast Wx was the only orthosis to fully dry in 45 minutes. Conclusion: Both orthotic brace systems provide superior water-resistant properties to traditional cotton-lined plaster cast or fiberglass Delta Dr. cast liner systems.

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Section: Distal Radius Fracture Castsmentioning

confidence: 99%

Comparison of Water Absorption and Drying in Distal Radius Fracture Casts and Orthoses

White¹,

Wyk²

2021

JAAOS Glob Res Rev

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“…Advances in air ltration, pre-surgical scrub, and surgical site preparation have all played a signi cant role in decreasing surgical site infections [6]. Despite this progress, studies have demonstrated that the vast majority of surgical site contamination in orthopedic surgical procedures is still due to airborne particles settling in the wound or on instrumentation [7]. Minimizing this source of surgical site contamination should be a high priority for improving patient surgical outcomes as well as decreasing risk and cost of procedures.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Bacterial Contamination of Casting Material in a Pediatric Population

Amato

Palyvoda

Vangipuram

et al. 2020

International Journal of Pediatrics

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Surgical site infection is a relatively common and devastating complication following pediatric orthopedic surgery. Many infections have been determined to be the result of settled airborne particles on surgical equipment and the sterile field. Fiberglass casts are commonly used orthopedic fixation devices before and after surgery; however, fiberglass casting material is expelled during the removal process and represents an uninvestigated area for the possibility of cast saw dust as a source of airborne bacterial contamination in an operating room setting. This study evaluates the prevalence and distribution of microbiota on 90 pediatric casts by collecting and culturing fiberglass cast material from 90 pediatric casts. Bacterial identification was performed using a Bruker Biotyper Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry device. 81 out of 90 casts (90%) showed evidence of microbial contamination. Isolated species were very diverse and ranged from normal skin flora to opportunistic pathogens. The 5 most commonly isolated organisms were Acinetobacter pittii, Enterobacter cloacae, Micrococcus luteus, Staphylococcus epidermidis, and Staphylococcus hominis. Further investigation is required to determine if casting material is truly a cause of surgical site infection.

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“…Según la literatura consultada, se estima que un 0.56% (2) , 15% (3,4) y 38% (5) de niños escayolados sufrirán una úlcera por presión iatrogénica dependiendo de la lesión y el tipo de enyesado, siendo los yesos sintéticos los que desarrollan mayor presión sobre los tejidos (6-8) y generándose dicha úlcera en los primeros días de llevar la inmovilización (9) . La prevención de estos problemas de salud asociados a la inmovilización es una tarea que debe emprenderse por parte de los enfermeros/as que realizan dicho procedimiento con el fin de minimizar los riesgos para la población, no solamente a la hora de realizarla con el mayor rigor científico y profesional, sino reforzando la educación sanitaria a los pacientes en el cuidado de la férula con el fin de prevenir complicaciones (10)(11)(12) .…”

Section: Introductionunclassified

Prevención de úlceras iatrogénicas por inmovilización terapéutica en niños con férula. Ensayo clínico

Hernández

Vicente²,

Sánchez³

et al. 2020

Enf Global

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Introducción: La inmovilización con férula de yeso en miembro inferior es un procedimiento frecuente para niños en los servicios de urgencias, el cual no está exento de riesgos relacionados con la inmovilidad y presión, sobre estos factores los enfermeros tienen que adoptar cuidados preventivos.Objetivo: Comprobar la eficacia del parche-talonera polimérico en la prevención de úlceras iatrogénicas en niños inmovilizados con férula de yeso en miembro inferior.Material y Método: Ensayo clínico aleatorio preventivo sobre pacientes pediátricos de 0 a 14 años que precisen inmovilización con férula de yeso en miembro inferior. Se realizó muestreo consecutivo no probabilístico simple ciego. Análisis estadístico descriptivo de las variables y test de la X2 con las variables aplicación del parche y aparición de úlceras.Resultados: Se obtuvo una muestra de n=74 pacientes. Se objetivó úlcera en 21.7% de pacientes, piel íntegra (48.2%) y eritema que palidece 30.1%. Se aplicó el test de la X2 para las variables aplicación de parche polimérico y aparición de úlcera, obteniendo X2=0.135 con p=0.713, y por tanto, no existe significación estadística entre estas dos variables.Conclusiones: No existe relación directa entre la prevención de úlceras por presión en niños inmovilizados con férula de yeso y la aplicación de parche protector polimérico. Es fundamental que los enfermeros/as ofrezcan una educación sanitaria de calidad en los cuidados y mantenimiento de la férula para evitar complicaciones. Introduction: Immobilization with plaster cast in lower limb is a frequent procedure for children in the emergency services, which is not without risks related to immobility and pressure, on these factors nurses have to adopt preventive care.Objective: To verify the efficacy of the polymeric heel patch in the prevention of iatrogenic ulcers in children immobilized with a plaster splint in the lower limb.Material and method: Preventive randomized clinical trial on pediatric patients aged 0 to 14 years who require immobilization with a lower limb cast cast. Simple blind non-probabilistic consecutive sampling was performed. Descriptive statistical analysis of the variables and X2 test with the application variables of the patch and the appearance of ulcers.Results: A total sample of n = 74 patients was obtained. Ulcer was observed in 21.7% of patients, whole skin (48.2%) and erythema that pales 30.1%. The X2 test was applied for the application of polymer patch and ulcer appearance variables, obtaining X2 = 0.135 with p = 0.713, and therefore, there is no statistical significance between these two variables.Conclusions: There is no direct relationship between the prevention of pressure ulcers in children immobilized with plaster splint and the application of polymeric protective patch. It is very important that nurses offer a quality health education in the care and maintenance of the splint to avoid complications.

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

Cited by 27 publications

References 35 publications

Comparison of Water Absorption and Drying in Distal Radius Fracture Casts and Orthoses

Comparison of Water Absorption and Drying in Distal Radius Fracture Casts and Orthoses

Prevalence of Bacterial Contamination of Casting Material in a Pediatric Population

Prevención de úlceras iatrogénicas por inmovilización terapéutica en niños con férula. Ensayo clínico

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