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 look like they could easily lacerate the skin, but they are quite safe.

• 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.

• 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.

• Score the cast along its long axis.

• 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.