Applying a cast français  deutsch

A cast consists of stockinette, padding, casting bandages and covering bandages, if necessary.

Stockinette and padding
The protective layer next to the skin is made of stockinette and padding. After the extremity is in the position in which it should be fixed, a tubular knitted fabric called stockinette is put on. It prevents that the following cotton wool bandages slip or cause irritations on the skin. The padding should be thicker in these places where bones are located immediately under the skin, otherwise injuries by virtue of increased pressure occur (Complications). It is recommended to wrap paper bandages on the cotton wool to compress the padding. Otherwise the padding will be pressed later when the patient wears the cast and the cast will not fit anymore.

Stockinette and padding should exceed the planned borders of the cast by 10 and 5cm respectively. After the plaster or fibreglass rolls are wrapped, one trims and folds down padding and stockinette at both ends. It is secured under the last layer of fibreglass or plaster. So padded borders are made.

Picture from: Stenger 'Verbandlehre'
Folding down stockinette and padding below the knee for a short leg cast.

Casting bandages
The padding is followed by the layer of casting bandages. This layer can be made out of plaster or fibreglass. To decide which material is the right see section Plaster or fibreglass.

Before use, the rolls of plaster or fibreglass are dipped in water and soaked completely. In the case of plaster it is suggested to include longuettes in the cast. These are 4-6 layers of plaster bandages, which are applied as splint after dipping in water. One can put them on the padding or on the first plaster layer. Longuettes fortify the cast, so less circular bandages are needed and the cast will be lighter. In the case of fibreglass a longuette is only on the sole of a walking cast necessary.

The cast must fit the shape of the injured arm or leg correctly to provide the best possible support. All the wrinkles should be smoothed carefully out. Finally, padding and stockinette are folded down and secured under the last layer of casting bandage. Before the material is set further corrections can be done.

Covering material
Especially plaster casts get dirty after a period of time. Hence, it is suggested to put a stockinette or a tubular netting on the cast. Both can be washed or changed easily.

See the characteristics of applying special types of casts.