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Effects of Cast Immobilisation on Skin Barrier Function
Chin Yee Woo1, Mark Ja Koh, Winnie Ky Fung
1Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore.
Annals of the Academy of Medicine, Singapore
|July 27, 2020
Summary
Pediatric cast immobilization causes moderate skin issues, including increased water loss and hydration. Itch and odor also worsened, highlighting the need for improved casting materials.
Area of Science:
- Dermatology
- Orthopedics
- Pediatrics
Background:
- Cast immobilization is standard for pediatric fractures but causes skin irritation.
- Children and adolescents frequently report discomfort under casts.
Purpose of the Study:
- To quantitatively and qualitatively assess cast immobilization's effects on pediatric skin.
- To evaluate changes in skin barrier function and subjective symptoms.
Main Methods:
- Recruited 60 pediatric patients (6-17 years) with fiberglass casts.
- Measured transepidermal water loss (TEWL), stratum corneum (SC) hydration, and hair density before and after casting.
- Patients completed weekly questionnaires on itch, malodor, warmth, and dampness.
Main Results:
- Increased TEWL and SC hydration were observed post-casting at most sites.
- No significant changes in hair density were noted.
- Increased itch and malodor scores were reported throughout the casting period.
Conclusions:
- Cast immobilization for up to 4 weeks moderately impacts pediatric skin barrier function.
- Significant changes in TEWL, SC hydration, and subjective symptoms were observed.
- Further research into improved casting materials is recommended to enhance patient satisfaction and skin health.
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