Parekh Amit, Moon John, Roberts David, Schreiber Verena M
Northshore University Health System, Evanston, IL, USA.
University of Illinois at Chicago, Department of Orthopaedics, Chicago, IL, USA.
J Pediatr Soc North Am. 2024 Mar 29;7:100028. doi: 10.1016/j.jposna.2024.100028. eCollection 2024 May.
Keeping casts dry is a challenge in pediatric Orthopaedics. A wet cast risks skin complications and generally requires a cast change resulting in unplanned visits and increased health care costs in patients undergoing cast immobilization. Previous research on the effectiveness of cast covers has only reviewed adult models. We evaluated the efficacy of different commercially available cast covers and do-it-yourself (DIY) methods for keeping casts dry in different-sized pediatric arm models and compared the relative costs of using each method.
Short arm casts were applied to plastic mannequin arms representing pediatric patients ages 3, 6, and 12 years old. Different cast covers or DIY methods were applied over each cast and the limbs were then submerged in water for 1 minute. Water absorption was calculated by comparing the mass before and after submersion as measured with a digital scale. Each test group had 6 trials as determined by a power analysis. Statistical analysis was done using a nonparametric test with additional post-hoc analysis. Cost-effectiveness was estimated for typical materials needed for use over a 6-week period.
A plastic bag and duct tape were the most effective in keeping a cast dry. Other DIY methods (plastic bag and rubber bands, adhesive film) were not effective. There were several highly effective commercial cast covers across age groups, including Bloccs, Seal-Tight, and DryPro. Other commercial cast covers tested had inferior performance. Of the effective methods, a single plastic bag and duct tape were the most cost-effective.
DISCUSSION/CONCLUSIONS: A plastic bag and duct tape was overall the most clinically and cost-effective method of avoiding a wet cast, with good to excellent results across arm size/age groups. Findings from this study may better inform patients about ways to keep casts dry, avoid unnecessary visits for cast changes, and decrease associated costs and risk of complications.
(1)A plastic bag and duct tape were the most effective methods for keeping a cast dry across various arm sizes seen in pediatric Orthopaedics.(2)Other DIY methods (plastic bags and rubber bands, adhesive film) were ineffective, and should not be recommended.(3)Performance of commercial cast covers was variable. Several commercial cast covers (Bloccs, Seal-Tight, DryPro) were effective, but others (Walgreens, Curad) were not.(4)Amongst effective methods, a plastic bag and duct tape were also the least expensive. II,
保持石膏干燥在小儿骨科中是一项挑战。湿石膏有引发皮肤并发症的风险，通常需要更换石膏，这会导致接受石膏固定治疗的患者计划外就诊并增加医疗费用。先前关于石膏套有效性的研究仅回顾了成人模型。我们评估了不同市售石膏套和自制方法在不同尺寸小儿手臂模型中保持石膏干燥的效果，并比较了使用每种方法的相对成本。
将短臂石膏应用于代表年龄为3岁、6岁和12岁小儿患者的塑料人体模型手臂上。在每个石膏上应用不同的石膏套或自制方法，然后将肢体浸入水中1分钟。通过比较用数字秤测量的浸水前后质量来计算吸水率。根据功效分析，每个测试组进行6次试验。使用非参数检验和额外的事后分析进行统计分析。估计了6周期间使用的典型材料的成本效益。
塑料袋和 duct 胶带在保持石膏干燥方面最有效。其他自制方法（塑料袋和橡皮筋、贴膜）无效。有几种跨年龄组的高效商用石膏套，包括Bloccs、Seal-Tight和DryPro。测试的其他商用石膏套性能较差。在有效的方法中，单个塑料袋和 duct 胶带最具成本效益。
讨论/结论：塑料袋和 duct 胶带总体上是避免石膏变湿的最具临床和成本效益的方法，在不同手臂尺寸/年龄组中效果良好至极佳。本研究结果可能会更好地告知患者保持石膏干燥的方法，避免不必要的石膏更换就诊，并降低相关成本和并发症风险。
（1）塑料袋和 duct 胶带是在小儿骨科中不同手臂尺寸下保持石膏干燥的最有效方法。（2）其他自制方法（塑料袋和橡皮筋、贴膜）无效，不应推荐。（3）商用石膏套的性能各不相同。几种商用石膏套（Bloccs、Seal-Tight、DryPro）有效，但其他的（Walgreens、Curad）无效。（4）在有效方法中，塑料袋和 duct 胶带也是最便宜的。II,
