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BODYCAST - THE OFFICIAL JOURNAL OF THE CSOT A prospective evaluation of patient experiences and skin conditions during and after cast immobilization By Dion Maxwell and Allan J. Dalton Reprinted with permission from Journal of the National Association of Othopaedic Technologists, 8(2), Winter 2002, 12-17. Abstract Immobilization via casting for closed fractures is an accepted and common practice, which can lead to skin becoming dry, itchy and odourous . The purpose of this study was to discover how burdensome, if any, are casts with respect to itch, perspiration and odour. Fifty patients with closed undisplaced wrist fractures were recruited to participate in the study. Patient demographics were collected on the day of the cast application. After cast treatment, skin conditions were evaluated by the investigators in addition to the eliciting information regarding discomfort, itch, perspiration and odour from the patients. Quantitative analysis was undertaken using descriptive statistical tests. Age ranged from 1 to 66 years (mean 37) and 54% were female. The levels of discomfort, itch, perspiration and odour while wearing a cast were 40%, 41% and 53% respectively. Discomfort (r=0.33492, p=0.0214) and perspiration (r=0.48056, p=0.0006) were found to be correlated with odour. Skin conditions upon cast removal as observed by the investigators were as follows: 24% excellent, 48% good, 25% average and 3% poor. This study conclusively illustrates that patients requiring cast immobilization can expect to experience mild to moderate itching, perspiration and odour significant enough to be of bother. Introduction Immobilization via casting for casting for closed fractures is an accepted and common practice, but there are drawbacks that accompany this form of treatment. Perhaps the most significant drawback endured by the patients is the compromise to the skin underneath the cast. Anecdotally, it is well-accepted that encasing a limb in a rigid dressing for a prolonged period creates a hospitable breeding ground for bacteria and generally results in the skin becoming dry, itchy and odourous (Harkess, Ramsey, & Harkess, 1996). This anecdotal notion, however, has no been scientifically supported in the literature. In fact, an extensive review of the literature (MEDLINE [1966 to present] and CINAHL [1982 to present]) yielded no published work assessing patient experiences and skin conditions during and after conventional cast immobilization. Therefore, the purpose of this investigation was to discover, delineate and document patient experiences and skin conditions underneath conventional casts. This abstract is a portion of the article
which appears in the Summer 2005 issue of BodyCast. |
