Plaster Removal

 PLASTER REMOVAL

GENERAL GUIDELINES: 

Reassure patient and inform that the saw blade may get hot.

1. Support and position limb.

2. The noise of the electric cutter frightens some children, and so shears may be used.

3. A plastic skin protector strip may be inserted between the cast lining and a patient’s limb in the area where cutting will occur to protect the skin.

4. Cut steadily and smoothly while conversing with the patient to divert attention.

REMOVAL OF PLASTER CAST WITH STILLE’S PLASTER SHEARS:

1. Draw guidelines down the side of the cast making sure that the line does not run directly over any bony prominences. 

2. Insert the blade between the plaster and the padding wool, parallel to the skin with the handle held steadily in the vertical position. The other blade cuts through the cast from above, its handle should be parallel to the cutting line at rest. 

This is the starting position, and if the blades are incorrectly aligned, the lower blade will press into the flesh causing bruises or even lacerations.

3. After each cut, the blades should be realigned before the next cut is made. This prevents the skin wrinkling in front of the shears. 

4. Use the plaster benders to open out the cast.

5. Use scissors to cut the guaze padding. 

REMOVAL OF PLASTER CAST WITH ELECTRIC CUTTER (MORE COMMONLY DONE):

1. The electric cutter must only be used to cut completely padded casts.

2. Position the blade at the start of the guideline, apply gentle pressure and move the cutter smoothly along the line. 

   
   

3. The electric cutter should always be used carefully especially near bony prominences such as the medial border of the foot leading to the big toe. 

4. Rest of the procedure is same as above.

CARE OF THE PART AFTER CAST REMOVAL:

• Examine for any injury.

• Instructions for the patient:

1. Wash and dry the part.

2. Gentle massage with oil, or cream, may help to restore normal nutrition and elasticity to the skin.

3. Some swelling of the limb is expected after a period of immobilization, especially in the lower limbs.Excessive swelling may be managed by elastic wrapping or intermittent limb elevation.

4. Continue exercises as advised and resume normal activity gradually, resting the part at regular intervals.

Practical tips and tricks:

1. Never try to cut around corners. Always remove the blades and cut from the opposite end of the line to meet the end of the cut already made.

2. When using shears, keep the elbows relatively still and apply the cutting force from the shoulder girdle and chest muscles. This gives a more controlled power and saves energy.

REFERENCE VIDEO LINK:

Plaster cutting with electric cutter: https://youtu.be/3yW_-Aq0O0Q 

Written by our guest author - Rishabh Rawat

Illustrations by Anveshi Nayan

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