Cast Care

GENERAL INFORMATION:

What is a cast, and why might I need one? A cast is a hard piece of plaster or fiberglass that is placed around a body part. There are many reasons why a person may need a cast. After a bone fracture (break) a cast helps keep bone pieces in the right place, and stops them from moving. If you have surgery to put together broken bones, a cast helps support the area while it heals. If you injure a ligament (tissue that connects one bone to another bone) a cast can help the ligament rest and heal. Casts may also be used to correct bones that did not grow as they should. In this case, you may need several different casts applied over a period of time.

What are the risks of wearing a cast? You may have any of the following:

• Allergic reaction: You may have an allergic reaction to the cast, and your skin may become itchy, swollen, and red.
  
  
• Burns: Heat is produced while the cast hardens. This can make your skin red and painful, and may burn it.
  
  
• Compartment syndrome: Compartment syndrome is a condition where blood flow to body areas is blocked by swelling. When there is swelling, your body area gets bigger, and the cast may look and feel very tight. You may feel pain, or numb (lose feeling) in the area where the cast is. Other signs of compartment syndrome include pain that does not go away even after taking pain medicine. You may also find that raising the body part where the cast is up on pillows, and putting ice on it does not decrease the swelling.
  
  
• Infection: You may have a wound after having surgery, or other sores on your body under your cast. These wounds can get infected if they are not watched and cared for. If the wounds get infected, you may have pain and swelling, and a fever.
  
  
• Joint stiffness: You may have stiff joints. Joints are the areas in your body where two bones meet, such as your knees and elbows. You may have trouble moving body parts, such as an arm or leg, after it has been in a cast for a time. Your caregiver may teach you exercises to help you freely move your joints again.
  
  
• Muscle problem: Your muscles under the cast may get smaller and weak after being in a cast for a time. Ask your caregiver about ways to strengthen and increase the size of your muscles.
  
  
• Skin sores: You may have blisters, sores, or wounds if your cast is too tight. You may also have wounds if the skin under your cast is scratched.

What problems should I watch out for while wearing a cast? Get help from caregivers as soon as possible if you see any of the following:

• Sores, blisters, skin breaks, or other changes: The skin near your cast should be it's usual color and feel warm to touch. There should not be sores, blisters, or breaks in your skin around the edges of the cast.
  
  
• Changes in skin sensation (feeling): Pain, itchiness, burning, decrease in feeling, or weakness at or near the body area where the cast is.
  
  
• Decreased urination and bowel movements: You should be passing urine and bowel movements every day. Call your caregiver if you are not having regular bowel movements or if you are not able to urinate.
  
  
• Bad stains, smells, or drainage: You may smell something bad, see stains, or there may be drainage coming from the cast. You may also have a fever and more pain in the area.
  
  
• Swelling: The casted body part should have little or no swelling. Check for space between your skin and the cast. Check if your cast feels tighter than it has before. If possible, raise the casted body area to help decrease any swelling. If your arm or leg is casted, prop it up on pillows when you sit or lie down. Have it raised higher than the level of your heart.

How do I care for the cast while it hardens? Your cast may take up to 48 hours (two days) to completely dry and harden. It needs to be hard and very strong to hold the body part steady. Do the following:

• Do not bend, lean on, or hit the cast with anything until it completely hardens.
  
  
• Keep the cast clean and dry. Getting it wet will soften it and change its shape.
  
  
• Move and change your position every two hours to help the cast dry faster. Ask for help if you cannot move easily by yourself. Place the casted body part on something soft, such as a pillow. This will prevent the cast from getting flat in one area.
  
  
• Stay in a place with a slight breeze, and leave your cast uncovered to help it dry faster.
  
  
• Use the palm of your hand or hands if you need to lift your cast. Do not press on or pick up the cast with your fingers, as this can leave little dimples on it as it is drying.

How can I protect the cast from damage?

• Check for any cracks, dents, dimples, holes, or flaking areas on the cast every day.
  
  
• Do not break off rough edges or trim the cast. Let your caregiver do this for you.
  
  
• Do not let anyone push down or lean on any part of the cast because it may break.
  
  
• Keep the cast clean and dry.

How do I keep the cast clean and dry? Keep the cast clean and dry to prevent it from getting soft and weak. The cast may not be able to hold your body parts in place if it breaks or changes shape. If this happens, the body area in the cast may not heal well. Do the following:

• Cover your cast with a towel or a large T-shirt when you are eating. This will help prevent food and drinks from spilling on or into the cast.
  
  
• Keep dirt, sand, and powder away from the inside of your cast.
  
  
• Wrap the cast with towels or plastic trash bags while you take a bath. Wash the skin that is not covered by the cast with soap and water every day. Certain casts can get wet or even soak in water. Ask your caregiver if your cast needs to be kept away from water, or if it can go in water.
  
  
• You may use a hair dryer set on the lowest heat setting to dry a cast that gets wet. This may dry the cast faster than just letting it dry by itself. Make sure that the hair dryer is not blowing air that is too hot or you may get burned.
  
  
• Use a mild detergent and a washcloth to wipe dirt and grime off the cast.

How do I care for the edges of the cast? You or your caregiver may fix the cast edges to keep them smooth. This will help stop your skin from scraping against rough edges on the cast. Do the following:

• Cut pieces of waterproof tape about four inches long.
  
  
• Place one end of the tape under the inside edge of the cast and wrap it onto its outside surface.
  
  
• Overlap the tape strips until the edges of the cast are completely covered.
  
  
• Do not pull or fix any of the padding inside the cast. This could cause blisters and wounds.

What is windowing? Windowing is when your caregiver cuts away a small piece from the cast. He uses this opening to check and care for incisions (cuts) from surgery or other wounds. The piece that was cut out looks like a small window. The cast piece can be placed back on to close the opening. Closing the opening tightly will help prevent dirt from going in, and the skin under the window from swelling.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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