Here are the answers to the most commonly asked questions about how to take care of casts…
Can I get my cast wet?
It depends…If you have a plaster cast, it definitely cannot get wet. The plaster will become soggy and soft and no longer will it hold the fracture. A fiberglass cast will not fall apart if it gets wet. However, it can be difficult to get the inside of the cast dry again. This causes your skin to become soft and usually rather smelly. A blow dryer on the cool setting can help, but the smell and itching usually stay.
Cast covers can be hard to find. You can order them directly from Amazon.com by going to amazon.com and typing in “cast covers”.
Certain casts use a special gore-tex underlining, making it possible to swim, shower, etc. While this seems like a great idea, not every orthopedic surgeon will use gore-tex because it costs 10 times more than the usual underlining and is not especially “user-friendly”. If you must have a gore-tex underlining, expect to pay out of pocket for it because most insurance will not pay for it.
What can I do about itching?
Itching is a common problem under a cast! There are not great solutions, but we often see some rather creative but unsuccessful attempts to solve the problem. First, it is generally not a good idea to stick something down your cast so scratch your itch. The reason is that it can mess up the underlying padding of your cast making the problem worse, and scratch your skin causing a sore that you cant see. If you must scratch, a smooth butter knife rather than a coat hanger or pen is the best tool. We DO NOT recommend this, however. Try distraction, mental exercises, or scratching the other arm rather than sticking something down your cast.
Can I stick anything down my cast to scratch?
Bad idea. This can scratch your skin or worse yet, get stuck in your cast so you cant get it out! If you absolutely have to stick something down your cast to scratch, use a smooth butter knife, not a coat hanger or other sharp object. Things have a curious way of getting stuck in a cast. When this happens, it is likely to cause sores or breakdown of the skin under the cast.
Are there waterproof casts?
Yes, but their use is limited. Gore-tex underlining for a fiberglass cast allows it to get wet and dry out. However, gore-tex costs about 10 times more than regular cast material and insurance will usually not pay for it. Therefore, if you must have a “swimming cast”, expect to pay extra out-of –pocket for it\.
I got something stuck in my cast. How do I get it out?
We find an incredible assortment of things that have seemingly jumped into kid’s casts or were placed there by Aliens! The problem with having something stuck in your cast is that it can cause a sore in the skin. Once something is caught up in the cast, it is very difficult to get out without removing the cast. Therefore, it is best to “fess up” that something is stuck in the cast and have it removed. Don’t try to do this at home; it can be dangerous and the fracture may lose alignment in the process.
Can I write on my cast?
Yes. Cast decorations, signing, and other forms of artwork will not damage your cast. Remember, what ever you put on your cast, you’ll have to live with until you have it off. This is one of the great advantages of cast decoration over tatoo’s: they don’t last forever.
How do I care for a SPICA CAST?
A SPICA cast is the hardest cast to care for. When the entire lower half of your body is in a cast, toileting is obviously an issue, especially if your child is not “potty trained”. The hardest problem is keeping the cast clean and dry so the surrounding skin does not get a severe diaper rash.
The trick is to keep the cast as dry as possible. A repeatedly soiled cast can develop an odor that can clear a room in a few seconds! The harder you try to keep it clean, the better you will be. However, you should accept the fact that even if you are the most perfect parent in the world, the cast will have a certain “bouquet” and the time of removal that you will be ready to forget.
Here are some tips that we find helpful:
- Use two diapers. Use a smaller one and tuck it up inside of the cast as a “first defense” against urine. Use a second diaper around the cast.
- Change the diapers often. Sorry, this is not the time to save the landfills from too many diapers. The sooner you change the diaper, the drier the cast will remain. In terms of overall all odor, you will be rewarded by frequent diaper changes.
- Elevate your child’s head slightly when they sleep. This prevents urine from immediately running up the back of the cast and getting the underlining wet. This can be like not changing a diaper for two months…very hard on the skin.
- When the cast gets wet, get it dry. The best way to protect the skin is to keep the skin dry. If the cast does get wet, then use a blow dryer on the cool setting to help dry it out. Place the child on their stomach, and this will help get air to the bottom area.
- Be careful about using powder or salves to dry the skin. These can accumulate just out of reach and turn into sludge……
How is a cast removed?
A cast is removed using a special device known as a cast saw. Cast saws are rather scary to children, because they make a lot of noise and would in their eyes appear to have the capability to cut their entire arm or leg off while removing the cast! A cast saw works by having the saw blade vibrate very fast. This makes it so when it comes in contact with something very hard like fiberglass, it will cut it, but when it touches something soft, it can’t cut that.
Will the cast saw cut me?
No. The cast saw vibrates very fast, but won’t cut through the skin. Have you doctor show you this before removing the cast so you won’t be scared by the saw.
Can I remove my own cast?
No. This is a bad idea. Cast material is very hard. With a lot of work, using sharp tools around the home, you could probably get your cast off, but at significant risk of life and limb. It is much safer to have your doctor remove your cast using tools specifically designed to do this.
How can I tell if there is too much swelling in the cast?
A properly applied cast should feel snug, but not painfully tight. If your cast was placed immediately after the break happened, then it is possible for there to be some further swelling inside the cast. Casts are rigid and unyielding. If the cast is too tight, you will experience increasing pain, and you will have more swelling in your fingers or toes. If this does not improve with elevation, your fingers or toes turn purple, or you lose feeling in your fingers or toes, you should seek immediate attention to have the cast split to allow for swelling.
What should I do if the cast seems too tight?
If the cast is too tight, and you are having symptoms such as excessive pain, swelling in the fingers, of loss of feeling in them, then the cast should be split or “bivalved”. This will allow for swelling to occur without putting too much pressure on your arm or leg.
If I had surgery on the arm and it is in a cast, how do I know that the incision is OK?
This is a common worry after surgery. Most incisions will heal very well under the protection of a cast. There is generally no need to change bandages, etc while the cast is in place. If you were do develop new onset of pain, a foul odor, or started having high fevers 5 days after your surgery, then you should seek immediate attention to check for infection of the surgical wound.
What are the signs of infection after surgery?
The signs of infection after surgery are usually not subtle. The typical signs of developing and infection after surgery are high fevers, new onset of pain once the initial surgical pain had resolved, drainage of pus like material from the wound, or a breakdown of the incision site. In this situation, you should immediately contact your doctor.