Reducing the Incidence of Cast-related Skin Complications in Children Treated With Cast Immobilization

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Rachel L Difazio1, Marie Harris, Lanna Feldman

  • 1*Boston Children's Hospital †Department of Orthopedic Surgery, Harvard Medical School, Boston, MA.

Journal of Pediatric Orthopedics
|December 20, 2015
PubMed

Insights

Adding padding to lower extremity casts significantly reduced skin complications in children. This quality improvement project found padding effectively lowered the incidence of these adverse events.

Area of Science:

  • Pediatric Orthopaedics
  • Quality Improvement
  • Patient Safety

Background:

  • Cast immobilization is a common pediatric orthopaedic treatment.
  • Data on cast-related skin complications in children is limited.
  • Understanding incidence and trends is crucial for improving care.

Purpose of the Study:

  • Establish baseline rate of cast-related skin complications.
  • Identify trends in affected children.
  • Design and evaluate an intervention to reduce complications.

Main Methods:

  • Prospective interrupted time-series design.
  • Data collected from September 2012 to September 2014.
  • Intervention involved adding heel padding and provider education.

Main Results:

  • Overall complication rate decreased from 13.6 to 6.6 per 1000 casts post-intervention.
  • Heel-specific complication rate dropped from 17.1 to 6.8 per 1000 lower extremity casts.
  • The intervention demonstrated a significant reduction in adverse events.

Conclusions:

  • Adding padding to the heel of lower extremity casts is effective.
  • This intervention significantly decreases cast-related skin complications.
  • Improved patient safety in pediatric cast immobilization.
Abstract

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