How To Remove a Cast

• Completion of the period of immobilization

• Numbness, tingling, increasing pain, or any other sensation indicating the cast is too tight

• Foreign body lodged between the skin and the cast

• Cast damage or wetness

• Concern about infection or injury to the skin under the cast requiring examination

• A date that is before the prescribed period of immobilization

• Injury to underlying skin (eg, abrasions, friction burn)

There are several different tools that can be used to remove a cast:

• Vibrating cast saw

• Cast spreader

• Blunt-tipped shears

Vibrating cast saws are designed to cut the cast without lacerating the skin.

Vibrating Cast Saw

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• Use a sheet or drape to collect dust generated from cutting the casting material.

• If the cast saw has an attached vacuum hose, use it to collect the dust.

• Wear appropriate eye and respiratory protection to protect against flying cast debris.

• The patient should be positioned to provide the operator with optimal access to the extremity with the cast.

Removing a Cast with a Saw

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Ekaterina/stock.adobe.com

• Introduce the vibrating cast saw to the patient, and touch it to your own palm to demonstrate that it does not hurt and will not cut the skin. The vibrating cast saw does not spin but instead oscillates back and forth to cut through rigid plaster and fiberglass, which keeps it from cutting through elastic tissue like skin.

• Score the cast along its long axis with the vibrating cast saw.

• Continue cutting the cast in the channel created by scoring until the underlying padding is reached.

• Cut the padding and stockinette with blunt-tipped shears.

• Insert the cast spreader between the cut cast edges.

• Spread the cast apart using the cast spreader.

• Remove the cast.

How To Remove a Cast

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• Clean the extremity of accumulated dried skin and oils using soap and water.

• Arrange or recommend appropriate physical therapy if needed (eg, for joint stiffness).

• To avoid injury to the underlying skin, do not continue to apply pressure with the cast saw at the same location after cutting through the plaster or fiberglass.

• Spreading the cast apart may be easier if both sides are cut rather than just one side.

• Brace part of the hand holding the cast cutter on the cast for better control.