Guillen Philip T, Fuller Corey B, Riedel Barth B, Wongworawat Montri D
Loma Linda University Medical Center, Loma Linda, CA, USA.
Hand (N Y). 2016 Mar;11(1):50-3. doi: 10.1177/1558944715614853. Epub 2016 Jan 14.
Many fractures are treated with casting which can cause complications likely from inability to wash the extremity. Gore-Tex-based waterproof cast liner has been compared with cotton liner and shown to be superior in physician and patient scoring but also has high cost and difficult application. The purpose of this study is to compare newer generation waterproof liners with traditional cotton liner. It is the first study to compare this new waterproof liner and cotton liner in a crossover model, allowing patients to swim in the pool with the cast.
Twenty patients (ages 3-30) with upper extremity injuries were randomized to waterproof-liner or cotton-liner casts made of fiberglass. Patients would switch cast liners halfway between their treatments to fulfill crossover criteria. All fractures were within a 2-week period from original incident. At each clinic visit, patients evaluated comfort parameters through questionnaires, and physicians rated skin condition. Patients were also asked which cast liner they preferred at the end of the study.
There were no unscheduled cast changes. The waterproof-liner group had better scores for odor (P = .041), sweat (P = .016), and overall physician-rated score (P = .038). There was no significant difference in other patient-rated parameters. Seventy-five percent of patients preferred waterproof casting to the cotton liner.
This new waterproof cast liner, compared with cotton cast liner, had better odor, sweat, and overall physician scores. The waterproof liners allow patients to rinse casts daily, and the majority of patients prefer waterproof to cotton liner.
许多骨折采用石膏固定治疗，这可能因无法清洗肢体而导致并发症。基于戈尔特斯（Gore-Tex）的防水石膏内衬已与棉质内衬进行比较，结果显示在医生和患者评分方面更具优势，但成本高且应用困难。本研究的目的是比较新一代防水内衬与传统棉质内衬。这是第一项在交叉模型中比较这种新型防水内衬和棉质内衬的研究，该模型允许患者戴着石膏在泳池中游泳。
20名上肢受伤患者（年龄3 - 30岁）被随机分配到由玻璃纤维制成的防水内衬或棉质内衬石膏固定组。患者在治疗中途更换石膏内衬以满足交叉标准。所有骨折均发生在受伤后2周内。每次门诊就诊时，患者通过问卷评估舒适度参数，医生对皮肤状况进行评分。在研究结束时，还询问患者更喜欢哪种石膏内衬。
没有计划外的石膏更换情况。防水内衬组在气味（P = 0.041）、汗液（P = 0.016）和医生总体评分（P = 0.038）方面得分更高。在其他患者评分参数方面没有显著差异。75%的患者更喜欢防水石膏而非棉质内衬。
与棉质石膏内衬相比，这种新型防水石膏内衬在气味、汗液和医生总体评分方面表现更好。防水内衬允许患者每天冲洗石膏，并且大多数患者更喜欢防水内衬而非棉质内衬。
