title: How to Avoid Cast Saw Complications.
abstract: BACKGROUND
  As casts are routinely used in pediatric orthopaedics, casts saws are commonly used to remove such casts. Despite being a viewed as the "conservative" and therefore often assumed safest treatment modality, complications associated with the use of casts and cast saws occur.
  
  
  METHODS
  In this manuscript, we review the risk factors associated with cast saw injuries.
  
  
  RESULTS
  Cast saw injuries are thermal or abrasive (or both) in nature. Thermal risk factors include: cast saw specifications (including a lack of attached vacuum), use of a dull blade, cutting in a concavity, too thin padding, and overly thick casting materials. Risk factors associated with abrasive injuries include: sharp blades, thin padding, and cutting over boney prominences. Because nearly all clinicians contact the skin with the blade during cast removal, appropriate "in-out technique" is critical. Such technique prevents a hot blade from remaining in contact with the skin for any significant time, diminishing the risk of burn. Similarly, using such technique prevents "dragging the blade" that may pull the skin taught, cutting it. It may be useful to teach proper technique as perforating a cast rather than cutting a cast.
authors.affiliation: Department of Orthopedic Surgery and Rehabilitation, University of Wisconsin-Madison, Madison, WI.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Halanski
mesh_terms: D002056:Burns / Q000209:etiology / Q000517:prevention & control; D002370:Casts, Surgical / Q000009:adverse effects*; D002648:Child; D020878:Device Removal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D055502:Secondary Prevention / Q000379:methods*