Document Detail

Effect of pressure applied during casting on temperatures beneath casts.
MedLine Citation:
PMID:  21926879     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : Burns and pressure sores are common injuries during cast application. Various factors such as water temperature, padding, and cast material layers may play a role in these injuries; however, the effect of cast molding on temperatures and pressures has not been investigated. This raises the following questions, does the application of molding during cast application: (1) alter skin level temperatures in a variety of cast materials? and (2) risk inducing either thermal injury or pressure necrosis?
METHODS: : An upper extremity model was created to measure pressure and temperature underneath casting materials. Cast padding, water bath temperature, and cast thickness were standardized. A 3-point mold was simulated using 3 casting materials-Fiberglass only, Plaster Only splint, and Plaster splint overwrapped with Fiberglass-while pressure and temperature were recorded.
RESULTS: : Pressure application led to a statistically significant (P<0.0001) increase in temperature at the sites where the mold was applied although absolute temperature did not reach the theoretical burn threshold of 49 to 50°C for the casting materials studied. With pressure applied, the Plaster/Fiberglass combination reached an average peak temperature of 47.9°C, which was maintained for up to 6 minutes. Neither Fiberglass nor Plaster Only reached peak temperatures of this magnitude (average of 42.7 and 43.6°C, respectively). Peak (369 mm Hg) and highest residual (21 mm Hg) pressures were below harmful levels.
CONCLUSIONS: : Pressure application during casting is a risk factor for burn injuries. Care should be taken when molding a plaster splint overwrapped in fiberglass by waiting until the plaster has fully cooled.
CLINICAL RELEVANCE: : Combined with other known risk factors, the pressure from molding a cast could increase the likelihood of causing cutaneous burns.
Brian J Deignan; Joseph M Iaquinto; Scott M Eskildsen; Cassandra A Woodcock; John R Owen; Jennifer S Wayne; Victoria G Kuester
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  31     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2011 Oct-Nov
Date Detail:
Created Date:  2011-09-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  791-7     Citation Subset:  IM    
*Departments of Orthopaedic Surgery †Biomedical Engineering, Orthopaedic Research Laboratory, Virginia Commonwealth University, Richmond, VA.
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