Help Shape the Future
of Foot Care!
Join the WholeFoot
What this article discusses:
Casts are very useful for many purposes in the orthopedic or podiatric clinic including various forms of tendonitis, sprains and other soft tissue injuries as well as fractures. Proper care of your cast is crucial for the successful treatment of your problem and for your safety.
While casts can be uncomfortable and the conditions that they treat can be painful, the cast itself should not be painful itself. If your pain increases or if the cast feels too tight, you should elevate the cast above the level of your heart. If this does not quickly alleviate the problem, contact your orthopedist or podiatrist’s office or the on-call physician immediately.
Itching is also quite common. Over-the-counter anti-histamines such as Benedryl (diphenhydramine) and non-drowsy anti-histamine, Claritin (loratadine) can help stop this. Never stick anything into the cast to scratch your skin, because it can damage your skin and cause potentially serious infections and wounds. The Cast Cooler (www.castcooler.com) is a suction device that uses a vacuum to suck air through the cast. It seems to improve itching and smell associated with cast wear.
Protect your cast when in the rain or in damp places. If the cast gets slightly damp, it can be dried with a blow dryer on low heat. If it gets wet, the cast should be changed because it can damage the skin.
If a cast rubs on your skin, wounds and blisters can occur. This should be immediately reported to your doctor. Any drainage from the cast not related to a surgical wound or ulcer should also be immediately reported to your doctor. These areas are most common at the ends of the cast, especially the top of the foot, the front of the shin, and around the inside or outside of the foot. They are easily and quickly treated with replacement of the cast and simple wound care if they are caught early.
Fiberglass cast surfaces can be abrasive. It is advisable to wrap the cast with an ace wrap at night to avoid damaging your sheets, other leg, or partner.
Smell can also be a common problem and can be helped by regular cast changes usually every three or four weeks. Avoiding heavy physical activity and exercising also will help. Do not pour powder down the cast as it can cake and damage the skin.
Showering/bathing with your cast
It is impossible to guarantee that your cast will remain completely dry during a shower or bath, but most people are unwilling to forgo showering or take a “sponge-bath” for the entire time that they will be wearing a cast. While showering, avoid directing the showerhead at the cast or leg. Never submerge the cast no matter how well it is protected.
Ideally, you should wet your body for a short period. Turn the shower off and soap and lather appropriately. Turn the shower back on for rinsing. This minimizes the chance of moistening the cast. An excellent way of controlling the water is to use a spray attachment to the faucet. These are available at most hardware and discount stores for $10-15.
Prepare the cast by taking a washcloth or hand towel and rolling or fold it into a tube. Tape or ace wrap this above the cast. Place the cast and towel completely within a heavy plastic bag and secure with a rubber band. If there are significant circulatory problems, then the rubber band should be very loose. If the cast is a lower extremity cast, then an ace wrap should be wrapped around the weight-bearing portion of the cast to avoid abrasion and tearing of the plastic bag by the cast.
Commercially-available cast protectors can be substituted for the plastic bag and can be obtained at most medical supply stores or online. The cost is about $30. Manypeople find them more convenient than plastic bags, but they also can leak. Placing the hand towel above the cast and below the cast protector is still advisable. The Drypro cast protector is slightly more expensive, but is the only cast protector on the market that I would feel secure enough with to skip the above preparation.
© 2013.WholeFoot, LLC. All rights reserved.