Figure 1-12. Finishing a cast.
c. Nursing implications. A cast without a smooth, unwrinkled finish is a potential
source of problems.
(1) Rough, unfinished cast edges will scrape or cut the skin. Broken skin
surfaces may become infected.
(2) Loose bits of plaster from an unfinished cast may become lodged inside
the cast, causing itching and irritation.
(3) Wrinkled or "bunched-up" edging may result in pressure areas and
potential skin breakdown.
1-19. CAST CUTTING
Casts may be cut for different reasons--to allow for wound dressings, to examine
a painful area, or to relieve pressure. Nursing personnel may be required to assist with
cast cutting at the bedside as an emergency measure.
a. Bivalving the Cast. Bivalving is the recommended method for emergency
cutting to relieve pressure. In bivalving, the cast must be cut along its entire length on
two sides (medial and lateral) and the base lining or padding cut completely down to the
skin. If the cast or the lining is split only part way, the congestion will be increased and
additional tissue damage will occur. To cut the cast, use a knife, a hand cutter, or an
electric cast cutter. Use bandage scissors to cut the base material. To use a knife for
emergency cast cutting, follow these steps.