View Full Version : Removal of Plaster Jackets
7th December 2006, 03:31 PM
My little boy Niall was diagnosed with a 40 degree curve at aged 2yrs. He is now 3yrs and adjusting well to life in a plaster jacket The curve is stable at 40 degrees.
Has anyone any advice on ways of coping with the removal of the plaster jacket,as it is currently done with Plaster shears and a great deal of force. Niall finds this extremley distressing. The medical staff assure us that use of the Plaster saw is not viable as the noise would be even more frightening. Does anyone have experience of this and maybe have some tips/advice. We would be very grateful.
7th December 2006, 03:49 PM
Welcome to SSO! :welcome2:
I'm so sorry that your little boy is getting distressed by the removal of his casts. I had infantile idiopathic scoliosis, and wore casts throughout my childhood from when I was a few months old until I was ten.
I remember them using plaster shears and a hand saw to remove my casts before they had a special plaster saw at my hospital. The plaster shears seem very big and quite brutal to a very young child, because there's so much force involved. Blimey, it's all coming back to me.....heh!
I don't know if the staff at your hospital use the same sort of plaster saw as they did at mine, but here is my experience of it....
The plaster saw is extremely noisy, and it vibrates the cast as it cuts through it, which doesn't feel at all nice. It's over very quickly though, probably a lot quicker than using the plaster shears.
The saw quite frightening because when it's cutting so close to your body, you get scared that it will cut you - but it has been designed so that this is impossible. It needs a lot of pressure before it will start cutting, so as soon as it is through the hard plaster it switches itself off. The plaster theatre technician used to demonstrate this on the back of his arm.
If this is the sort of saw that they use, you could maybe ask that they try it next time Niall needs his cast removed. Explain to Niall that it will be veryvery noisy and buzzy, but it will work very quickly so that will be nicer than the plaster shears. Get them to demonstrate that it can't possibly hurt him, and if he gets really distressed when they start using it, have them switch back to the shears.
Hope this helps......whereabouts in the world are you? Which hospital do you go to? Does Niall have idiopathic or congenital scoliosis?
Sorry for all the questions, but please do tell us more about Niall :D
7th December 2006, 04:32 PM
I think they may be right about the saw being scarier. It can't cut skin but if it does come in contact with skin, it will produce a friction burn.I hated it.
The shears is unfortunately unpleasant for small kids too but may be the lesser of two evils.
7th December 2006, 04:37 PM
Oh yes, I had a friction burn from the saw across my tummy once. Not nice! :-(
As Niall gets older, you could try emphasising how good he's going to feel as soon as the cast is off. Make it sound like something to look forward to, rather than something to be dreaded. It's such a lovely feeling to have air on your skin after a couple of months in a cast. Plus, you can have a bath!!!! So, do try taking his mind off the cast removal process by talking about that :-)
7th December 2006, 05:06 PM
Thank you for your helpful comments and experiences, will try and continue with the distraction techniques and speak again to the hospital staff about the saw. The risk of friction burns is something we had not thought of. His curve is idiopathic an d he is under the care of the general spines consultants at Manchester Childrens Hospital. We live in Stockport near Manchester.
Jacke and Niall :-)
7th December 2006, 05:16 PM
We have a member called Andrea, whose 4 year old daughter has an idiopathic curve of about 60 degrees and is being treated with casts at the Royal National Orthopaedic Hospital in Stanmore. I'm sure she'll be along to talk to you herself soon :-)
I hadn't heard of children being treated with casts in Manchester before, so that's good to know! Treatment around the country seems to vary, with some hospitals advising that you "watch and wait" - and you can't afford to muck about with infantile scoliosis.
8th December 2006, 12:23 PM
Hi Jacke and welcome to SSO. Toni's right - Erin is treated in London with plaster jackets. She actually prefers the shears as the noise of the saw frightens her, although we will get to the point where the cast is too thick for them to cut through with the shears. I hadn't come across friction burns before - in fact, on the one occasion that they did use the saw, they did it on her hand first to show her it didn't hurt. I wouldn't have thought burns would be an issue in the cast as there is a lining that the saw won't cut through - they have to cut that with scissors - so the saw will hit that before it comes into contact with skin.
If I were you, I'd ask for the saw next time and give it a go. We had the same problem with the mask for a GA. She hated it, but they said she was too small for a line in her hand. But they gave it a go and we haven't looked back.
Best of luck and keep in touch
10th December 2006, 09:34 PM
Billy has only had one cast removed on his back from postop fusion, but he wears an ankle foot orthosis that requires plaster casting of foot to knee fairly often (so they can make a form to mold brace to...)... At two years old, the child WILL NOT like anything they do, as both options are scary to them. The best thing I've found is to chose the method that is quickest so it's over as fast as possible, so the soothing can begin. Usually a trip to the hospital gift shop, LOL... ;)
Billy has had at least ten to twelve casts cut off with the plaster saw, and has never had a friction burn from it. As long as the person doing the sawing isn't trying to push too hard, it shouldn't be a problem...
Good luck whatever you decide!
27th December 2006, 03:17 PM
it was very interesting to read your post. My little boy Daniel (22 months) had his plaster cast removed in December. The last one he had removed in September was cut off by me and the nurse and apart from being horrible inside and his skin looking not very nice, it was not too traumatic.
His latest removal of his cast was a nightmare, and I am really really anxious about March when we have to get this one taken off. There was no bed for us on the ward so he had to have it taken off in the childrens casualty bit. A horrible saw was used and for 15 minutes he was completely terrified and I had to hold him down. When the cast was taken off his poor body looked dreadful. Really, really skinny and a horrible pressure sore on his back, that just made me feel awful, I burst into tears and really had to use all my courage not to run out with him and not go back.
The fixed his new cast with a hole in the back so the pressure sore could heal, which it has done, and his also had his back x-rayed, and according to the plaster man, it is straight!
I have an appointment in January with the back surgeon to talk over things, but all I know is that I do NOT want to go through that again! I hope to try and do it at home, and then he can have his 3 monthly bath with me and not be so terrified again.
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