Every summer in the Division of Orthopaedics we know to count on one thing: The warmer it gets, the more fractures—or broken bones—we see, and the more casts we apply.
That’s because kids are playing outside more (that’s a good thing!), but they’re also generally playing harder and are more prone to accidents and injuries that result in broken bones.
About 25 years ago when waterproof casts were first developed, we knew they were a great idea for the summer months. It used to be that a cast could rob a child of almost an entire summer because the cast wasn’t allowed to get wet.
But waterproof casts have changed all that.
Cincinnati Children’s was one of the first hospitals to start using waterproof casts because we saw immediately that they grabbed the interest of parents.
There can be difficulties in putting on waterproof casts versus traditional casts. But, driven by our desire to satisfy our patients, we worked through those challenges and now have a staff of 16 orthopaedic cast technicians (ortho techs) who are trained at applying this type of cast. And they’re so good at it that they’re often asked to train others on their methods.
What’s Great About Waterproof?
Casts are made up of two layers—a soft inner layer, and a hard outer shell (which used to be made of plaster and now is typically made of fiberglass). The secret to waterproof casts is in the first layer—the one that comes in direct contact with the skin. That material is made of a special material that doesn’t absorb water. Waterproof casts offer all the benefits of traditional casting plus some additional benefits of being waterproof:
- Waterproof casts don’t harbor mildew and bacteria the way traditional casts do. (Note: This also means they’re generally not as stinky as traditional casts!)
- They’re durable. Oftentimes a child in a cast can return to playing certain sports while wearing the cast.
- Because the child can bathe regularly, he or she stays cleaner, and so does the cast.
- The casts dry quickly.
- No prep time is needed before bathing or showering, since it’s not necessary to cover the cast to keep it from getting wet.
In addition to waterproof casts being great in the summer, we have discovered they also work really well in the winter, because it’s so easy for kids to take baths and showers with them on. We now use them almost exclusively because of that.
There are a few cases in which we don’t apply waterproof casts. One is when open skin wounds are present at the area that needs to be casted. (In this case, we try splinting the fracture for a bit longer; once the wounds are healed, then we put on the cast.) And we use traditional casts on patients who have had a prior allergy to waterproof casting material.
Taking Care of Waterproof Casts
There are two important things to remember when caring for a waterproof cast:
- It is recommended that you get a waterproof cast wet every day. The material could stick to the skin if it doesn’t get wet daily.
- A waterproof cast should be rinsed with clean tap water after swimming in a chlorinated pool, salt water, lake, or river. Cleaning the elements (chlorine, salt, dirt, etc.) out of the cast helps reduce the risk of skin irritation.
As with any cast, there are other care recommendations to follow, which our ortho techs review with each patient and family at the time of casting.
Upping the Fun Factor
Casts have come a long way in the past few decades. Rather than just plain white plaster, our fiberglass casting material comes in 10 different colors. (Recently pink camouflage has been a hit!) We often apply multiple colors in patterns, such as alternating stripes. On top of that, we started offering glitter as an option when our techs discovered the glitter dries to the cast and doesn’t flake off. If at all possible, it seems casts have gotten even cooler.
We are so grateful for the technology and people behind waterproof casts. This is an advancement in medicine that makes life much easier for both kids and parents. That’s the type of progress we like to see in our field and the new options that we are always excited to offer our patients.
Editor’s Note: Waterproof casts applied at Cincinnati Children’s are regularly covered by insurance and do not require special payment beyond what is typically due at the time of the appointment.