A cast, typically constructed from plaster or fiberglass, immobilizes a fractured bone or injured joint, allowing natural healing. Proper maintenance ensures the cast retains structural integrity and promotes skin health underneath. Attending to exterior cleanliness and the internal environment significantly improves comfort and helps prevent complications.
Cleaning the Exterior Surface
The cleaning approach for the exterior surface varies depending on the material. Fiberglass casts are durable and water-resistant; they can be gently wiped clean with a slightly dampened cloth, using mild dish detergent for tougher stains. Plaster casts are porous and fragile, requiring cleaning only with a barely damp cloth or specialized wipes, focusing on the soiled area. Avoid vigorous scrubbing, as it can weaken the structure or push moisture into the padding. After cleaning, the exterior surface must be dried completely to prevent softening or skin irritation.
Managing Internal Itching and Odor
The internal environment often causes discomfort due to accumulated dead skin cells, sweat, and moisture, leading to itching and unpleasant odors. Odor develops when bacteria and fungi thrive in the warm, damp conditions beneath the padding. To address internal moisture and reduce smell, aim a hair dryer set exclusively to the cool setting at the cast openings. This technique circulates air inside the cast, promoting evaporation and soothing the skin.
Resist the impulse to insert any object, such as pencils or coat hangers, into the cast to scratch an itch. Doing so can cause skin abrasions, potentially leading to infection or displacing the protective padding. Gently rubbing the skin around the cast edges with rubbing alcohol may provide relief by drying and cooling the skin, but this requires healthcare provider approval. Moisture-absorbing powders, like baking soda, can be sprinkled around the cast openings to manage external odor, but never dust them directly inside the cast unless recommended by a doctor.
Protecting the Cast from Water Damage
Preventing the cast from getting wet is the most important maintenance step, as moisture compromises its support ability and risks skin health. Plaster casts soften and disintegrate when wet, while fiberglass padding retains moisture, potentially leading to skin breakdown. Trapped water creates an ideal environment for bacterial growth, which can cause severe irritation or infection.
When bathing or showering, the cast must be kept completely dry. Specialized waterproof cast covers create a watertight seal and are the most reliable protection option. Alternatively, secure two thick plastic bags over the cast, taping the edges tightly to the skin above the cast using duct tape or a strong elastic band. Never submerge a non-waterproof cast in water. If the cast accidentally gets wet, immediately use a hair dryer on the cool setting to dry the internal padding, and contact the healthcare provider within 24 hours if it remains damp.
Signs That Require Medical Attention
While mild discomfort and itching are common, certain signs indicate a serious problem requiring immediate medical assessment. A sudden increase in pain not relieved by elevation or standard medication warns of swelling compromising circulation. Signs of poor circulation include numbness, persistent tingling, severe coldness, or a color change (blue or white) in the fingers or toes. Structural damage (soft spots, cracks, or significant chipping) means the cast’s ability to immobilize the bone is compromised and requires replacement. A persistent, foul odor accompanied by drainage, fever, or a burning sensation beneath the cast may signal a developing infection or pressure sore.