The benefits of plaster casting for lower-extremity burns after grafting in children

Plaster casts are frequently used for immobilization of extremities after grafting in our burn center. A retrospective study was undertaken to evaluate the efficacy of this technique versus posterior splinting in children with burns below the knee. Thirty-six of 165 patients who required skin grafts from October 1986 to October 1989 received skin grafts to the lower extremity below the knee. Twenty patients (56%) were casted and 16 (44%) were not. Various parameters were analyzed in order to compare the casted versus noncasted groups. Several statistical techniques were used to compare the two groups. The casted group had younger children, more rapid wound closure, fewer therapy treatments, and more complete graft take. When sheet and meshed grafts were compared, the same variables were significantly improved for only the group that received meshed grafts. The use of plaster casting after skin grafting is a cost-effective method of improving patient care.