Cast-saw injuries: Assessing blade-to-skin contact during cast removal: Does experience or education matter?

Kirstin C. Monroe, Sarah A. Sund, Blaise A. Nemeth, Kenneth J. Noonan, Matthew A. Halanski

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Cast-saw injuries are sustained during cast removal or splitting of a cast when a hot cast-saw blade touches the patient’s skin inadvertently during cast removal. Other studies have evaluated risk factors associated with saw-blade temperature, however, none have documented the number and duration of blade-to-skin contacts during cast removal. Methods: Using a pediatric long-arm model capable of detecting cast-saw blade contact, we tested the ability of health care providers to apply and remove casts before and after a brief education module. The total number and duration of “touches” between the saw and the model’s “skin” were recorded. Correlations between user “touches,” and experience and comparisons between pre- and post-education “touches” were performed. Results: Of the 18 study participants, 16 touched the model surface with the cast saw; 7 of the 18 participants maintained blade contact with the skin for > 1 second 22 times during the testing process. Participants with less experience averaged 20 (± 16) touches, whereas more experienced participants averaged 24 (± 19) touches (P = 0.7). Average number of touches was similar—before 22 (± 20) and after 25 (± 22); P = 0.5—participants completed an education module. No correlation between experience or participation in the education program was found with decreased number of blade-to-skin touches. Conclusion: Nearly all clinicians inadvertently contacted the underlying skin with the cast-saw blade. In our limited sample size, experience and education did not prevent this; therefore, minimizing time of contact and blade temperature may be more important factors in minimizing cast-saw injuries.

Original languageEnglish (US)
Pages (from-to)36-44
Number of pages9
JournalPhysician and Sportsmedicine
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Touch
Education
Skin
Wounds and Injuries
Temperature
Aptitude
Health Personnel
Sample Size
Pediatrics

Keywords

  • Cast
  • Complication
  • Iatrogenic
  • Injury
  • Saw

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Cast-saw injuries : Assessing blade-to-skin contact during cast removal: Does experience or education matter? / Monroe, Kirstin C.; Sund, Sarah A.; Nemeth, Blaise A.; Noonan, Kenneth J.; Halanski, Matthew A.

In: Physician and Sportsmedicine, Vol. 42, No. 1, 01.01.2014, p. 36-44.

Research output: Contribution to journalArticle

Monroe, Kirstin C. ; Sund, Sarah A. ; Nemeth, Blaise A. ; Noonan, Kenneth J. ; Halanski, Matthew A. / Cast-saw injuries : Assessing blade-to-skin contact during cast removal: Does experience or education matter?. In: Physician and Sportsmedicine. 2014 ; Vol. 42, No. 1. pp. 36-44.
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