Which cast care instructions should the nurse provide to a client who just had a plaster cast?

Cast care: Do's and don'ts

A cast can't do its job without proper care. Find out the basics of cast care, from keeping a cast clean to knowing when to call the doctor.

By Mayo Clinic Staff

If your child breaks a bone, a cast can help support and protect the injury as it heals. But a cast can't do its job without proper care. Find out more about the basics of cast care.

What are the different types of casts?

Casts are custom-made to fit and support injured limbs. There are two main types of casts:

  • Plaster casts. Plaster casts are easier to mold for some uses than are fiberglass casts. Plaster casts are also generally less expensive.
  • Fiberglass casts. These plastic casts are typically lighter and more durable than plaster casts. Also, X-rays penetrate fiberglass casts better than plaster casts — making it easier for your doctor to examine your child's bones while he or she is still wearing the cast.

What can be done to reduce swelling?

Swelling can cause your child's cast to feel tight and uncomfortable. To reduce swelling:

  • Elevate the affected area. For the first 24 to 72 hours after your child's cast is applied, use pillows to raise the cast above the level of your child's heart. Your child will need to recline if the cast is on a leg.
  • Apply ice. Loosely wrap an ice pack covered in a thin towel around your child's cast at the level of the injury. Wrapping the ice is important to keep the cast dry. Ice that's packed in a rigid container and touches the cast at only one point won't be as effective.
  • Keep moving. Encourage your child to frequently move the fingers or toes of the injured limb.

What can I do if my child wants to scratch under the cast?

A cast can cause your child's underlying skin to feel itchy. To relieve itchy skin, turn a hair dryer on a cool setting and aim it under the cast.

Don't allow your child to stick objects, such as a coat hanger, inside the cast to scratch his or her skin. This could cause an injury or infection.

Is it OK to get a cast wet?

That depends on the type of cast your child has. In general, casts are meant to stay dry. A wet cast can lead to skin irritation or infection.

Plaster casts and fiberglass casts with conventional padding aren't waterproof. Keep your child's cast dry during baths or showers by covering it with two layers of plastic, sealed with a rubber band or duct tape. Avoid swimming while wearing a cast that isn't waterproof.

A fiberglass cast that has a waterproof liner can get wet. Only certain types of breaks can be treated with a waterproof cast and liner. Ask your doctor if it's safe for your child to get his or her cast wet.

If the cast does get wet, you might be able to dry out the inside padding with a hair dryer. Use a low heat setting to avoid burning or irritating the skin.

How can my child keep his or her cast in good shape?

Try these tips:

  • Keep it clean. Keep dirt and sand away from the inside of your child's cast.
  • Skip toiletries. Avoid placing powder, lotion or deodorant on or near the cast.
  • Leave adjustments to your child's doctor. Don't pull the padding out of your child's cast. Don't trim the cast or break off rough edges without first asking your child's doctor.

What else do I need to know about my child's cast?

Contact your child's doctor immediately if your child:

  • Feels increasing pain and tightness in the injured limb
  • Feels numbness or tingling in the injured hand or foot
  • Feels burning or stinging under the cast
  • Develops excessive swelling below the cast
  • Can't move the toes or fingers of his or her injured limb, or they become blue or cold
  • Says the cast feels too tight or too loose
  • Develops red or raw skin around the cast
  • Develops a crack, soft spots or a foul odor in the cast, or gets the cast soaking wet and doesn't dry it properly

Caring for a child's cast isn't always easy. Remind your child that taking care of the cast will help minimize discomfort during the healing process.

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May 04, 2022

  1. Derby R, et al. General principles of acute fracture management. https://uptodate.com/contents/search. Accessed Jan. 25, 2018.
  2. Eiff MP, et al. General principles of fracture care. In: Fracture Management for Primary Care, Updated Edition. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2018. https://www.clinicalkey.com. Accessed Jan. 25, 2018.
  3. Care of casts and splints. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/recovery/care-of-casts-and-splints/. Accessed Jan. 25, 2018.
  4. Safran MR, et al. Cast care. In: Instructions for Sports Medicine Patients. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed Jan. 25, 2018.
  5. Pfenninger JL, et al. Casts immobilization and upper extremity splinting. In: Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, Pa.: Elsevier Mosby; 2011. https://www.clinicalkey.com. Accessed March 27, 2018.
  6. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 27, 2018.
  7. Dehn RW, et al. Casting and splinting. In: Essential Clinical Procedures. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2013. https://www.clinicalkey.com. Accessed March 27, 2018.

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How do you take care of a plaster cast?

Cast care.
Keep the plaster cast clean and dry at all times..
The cast usually dries completely in 48 hours. Allow it to dry naturally and keep it away from direct heat..
Avoid bumping or hitting the cast..
Do not paint the cast. This will close the pores of the plaster. Having friends decorate the cast using markers is OK..

How long do plaster casts stay on?

Plaster casts are made up of a bandage and a hard covering, usually plaster of paris. They allow broken bones in the arm or leg to heal by holding them in place, and usually need to stay on for between 4 and 12 weeks.

How Loose Should a plaster cast be?

A cast can become too loose, especially after the initial bout of swelling subsides. A child should not be able to remove the cast or significantly move the affected limb under the cast. Being able to place one or two fingers under a cast is appropriate.

What interventions should be included in the plan of care for a child who has recently had a cast applied to a fractured extremity?

Advertisement.
Elevate the affected area. For the first 24 to 72 hours after your child's cast is applied, use pillows to raise the cast above the level of your child's heart. ... .
Apply ice. Loosely wrap an ice pack covered in a thin towel around your child's cast at the level of the injury. ... .
Keep moving..