Efficiency and Safety: The Best Time to Valve a Plaster Cast

Efficiency and Safety: The Best Time to Valve a Plaster Cast

BACKGROUND:The act of applying, univalving, and spreading a plaster cast to accommodate swelling is commonly performed; however, cast saws can cause thermal and/or abrasive injury to the patient. This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-sa...

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Veröffentlicht in:Journal of bone and joint surgery. American volume 2018-04, Vol.100 (8), p.e49-e49
Hauptverfasser: Steiner, Samuel R.H, Gendi, Kirollos, Halanski, Matthew A, Noonan, Kenneth J
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container_issue 8
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container_title Journal of bone and joint surgery. American volume
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creator Steiner, Samuel R.H
Gendi, Kirollos
Halanski, Matthew A
Noonan, Kenneth J
description BACKGROUND:The act of applying, univalving, and spreading a plaster cast to accommodate swelling is commonly performed; however, cast saws can cause thermal and/or abrasive injury to the patient. This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-saw injury and increase spreading efficiency. METHODS:Plaster casts were applied to life-sized pediatric models and were univalved at set-times of 5, 8, 12, or 25 minutes. Outcome measures included average and maximum force applied during univalving, blade-to-skin touches, cut time, force needed to spread, number of spread attempts, spread completeness, spread distance, saw blade temperature, and skin surface temperature. RESULTS:Casts allowed to set for ≥12 minutes had significantly fewer blade-to-skin touches compared with casts that set for
doi_str_mv 10.2106/JBJS.17.00389
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This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-saw injury and increase spreading efficiency. METHODS:Plaster casts were applied to life-sized pediatric models and were univalved at set-times of 5, 8, 12, or 25 minutes. Outcome measures included average and maximum force applied during univalving, blade-to-skin touches, cut time, force needed to spread, number of spread attempts, spread completeness, spread distance, saw blade temperature, and skin surface temperature. RESULTS:Casts allowed to set for ≥12 minutes had significantly fewer blade-to-skin touches compared with casts that set for &lt;12 minutes (p &lt; 0.001). For average and maximum saw blade force, no significant difference was observed between individual set-times. However, in a comparison of the shorter group (&lt;12 minutes) and the longer group (≥12 minutes), the longer group had a higher average force (p = 0.009) but a lower maximum force (p = 0.036). The average temperature of the saw blade did not vary between groups. The maximum force needed to “pop,” or spread, the cast was greater for the 5-minute and 8-minute set-times. Despite requiring more force to spread the cast, 0% of attempts at 5 minutes and 54% of attempts at 8 minutes were successful in completely spreading the cast, whereas 100% of attempts at 12 and 25 minutes were successful. The spread distance was greatest for the 12-minute set-time at 5.7 mm. CONCLUSIONS:Allowing casts to set for 12 minutes is associated with decreased blade-to-skin contact, less maximum force used with the saw blade, and a more effective spread. CLINICAL RELEVANCE:Adherence to the 12-minute interval could allow for fewer cast-saw injuries and more effective spreading.</description><identifier>ISSN: 0021-9355</identifier><identifier>EISSN: 1535-1386</identifier><identifier>DOI: 10.2106/JBJS.17.00389</identifier><identifier>PMID: 29664854</identifier><language>eng</language><publisher>United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated</publisher><ispartof>Journal of bone and joint surgery. 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American volume</title><addtitle>J Bone Joint Surg Am</addtitle><description>BACKGROUND:The act of applying, univalving, and spreading a plaster cast to accommodate swelling is commonly performed; however, cast saws can cause thermal and/or abrasive injury to the patient. This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-saw injury and increase spreading efficiency. METHODS:Plaster casts were applied to life-sized pediatric models and were univalved at set-times of 5, 8, 12, or 25 minutes. Outcome measures included average and maximum force applied during univalving, blade-to-skin touches, cut time, force needed to spread, number of spread attempts, spread completeness, spread distance, saw blade temperature, and skin surface temperature. RESULTS:Casts allowed to set for ≥12 minutes had significantly fewer blade-to-skin touches compared with casts that set for &lt;12 minutes (p &lt; 0.001). For average and maximum saw blade force, no significant difference was observed between individual set-times. However, in a comparison of the shorter group (&lt;12 minutes) and the longer group (≥12 minutes), the longer group had a higher average force (p = 0.009) but a lower maximum force (p = 0.036). The average temperature of the saw blade did not vary between groups. The maximum force needed to “pop,” or spread, the cast was greater for the 5-minute and 8-minute set-times. Despite requiring more force to spread the cast, 0% of attempts at 5 minutes and 54% of attempts at 8 minutes were successful in completely spreading the cast, whereas 100% of attempts at 12 and 25 minutes were successful. The spread distance was greatest for the 12-minute set-time at 5.7 mm. CONCLUSIONS:Allowing casts to set for 12 minutes is associated with decreased blade-to-skin contact, less maximum force used with the saw blade, and a more effective spread. 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American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steiner, Samuel R.H</au><au>Gendi, Kirollos</au><au>Halanski, Matthew A</au><au>Noonan, Kenneth J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficiency and Safety: The Best Time to Valve a Plaster Cast</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><addtitle>J Bone Joint Surg Am</addtitle><date>2018-04-18</date><risdate>2018</risdate><volume>100</volume><issue>8</issue><spage>e49</spage><epage>e49</epage><pages>e49-e49</pages><issn>0021-9355</issn><eissn>1535-1386</eissn><abstract>BACKGROUND:The act of applying, univalving, and spreading a plaster cast to accommodate swelling is commonly performed; however, cast saws can cause thermal and/or abrasive injury to the patient. This study aims to identify the optimal time to valve a plaster cast so as to reduce the risk of cast-saw injury and increase spreading efficiency. METHODS:Plaster casts were applied to life-sized pediatric models and were univalved at set-times of 5, 8, 12, or 25 minutes. Outcome measures included average and maximum force applied during univalving, blade-to-skin touches, cut time, force needed to spread, number of spread attempts, spread completeness, spread distance, saw blade temperature, and skin surface temperature. RESULTS:Casts allowed to set for ≥12 minutes had significantly fewer blade-to-skin touches compared with casts that set for &lt;12 minutes (p &lt; 0.001). For average and maximum saw blade force, no significant difference was observed between individual set-times. However, in a comparison of the shorter group (&lt;12 minutes) and the longer group (≥12 minutes), the longer group had a higher average force (p = 0.009) but a lower maximum force (p = 0.036). The average temperature of the saw blade did not vary between groups. The maximum force needed to “pop,” or spread, the cast was greater for the 5-minute and 8-minute set-times. Despite requiring more force to spread the cast, 0% of attempts at 5 minutes and 54% of attempts at 8 minutes were successful in completely spreading the cast, whereas 100% of attempts at 12 and 25 minutes were successful. The spread distance was greatest for the 12-minute set-time at 5.7 mm. CONCLUSIONS:Allowing casts to set for 12 minutes is associated with decreased blade-to-skin contact, less maximum force used with the saw blade, and a more effective spread. CLINICAL RELEVANCE:Adherence to the 12-minute interval could allow for fewer cast-saw injuries and more effective spreading.</abstract><cop>United States</cop><pub>Copyright by The Journal of Bone and Joint Surgery, Incorporated</pub><pmid>29664854</pmid><doi>10.2106/JBJS.17.00389</doi><orcidid>https://orcid.org/0000-0002-5342-0821</orcidid></addata></record>
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title Efficiency and Safety: The Best Time to Valve a Plaster Cast
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