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A Fungus Among Us: Dangers of a Wet Cast

By Latasha Winston, MS, LAT, ATC

While most kids see having a cast as being “cool”, there is a certain level of responsibility to taking care of your cast.

Fractures often need to be immobilized in a cast for up to eight weeks at a time. These casts are made up of two different materials: plaster and fiberglass. The cast liner, made out of cotton, goes next to the skin.

To avoid problems, the cast must be kept clean and dry. Nothing should be placed inside the cast to scratch an itchy patch of skin. Keeping a cast clean and dry requires wrapping a towel and plastic wrap or a plastic bag around all openings during bath time. Baths are preferred to showers since it’s easier to protect the cast from water during a bath. Have your child rest the injured arm or leg on the ledge of the bathtub to keep it dry, and be sure not to submerge the cast in the water. Cast covers are available for purchase; however, they don’t always work. The only way to guarantee a cast stays dry is to wrap it securely and keep it out of all water.

If your child’s cast gets wet, the cotton lining will stay wet. This poses several problems. A wet cast will begin to smell moldy, and the dampness inside can cause a breakdown of the skin called maceration. Just as your fingers and toes turn wrinkly after being in the bath or a pool, having a wet cast on for too long will cause the same thing to happen. Extreme skin maceration can lead to an infection and possibly require surgery to clean the damaged tissue. If your child’s fracture required an open surgical procedure, such as a pinning, keeping the cast dry is every more important. The risk of infection increases tremendously due to the open wound from the surgical procedure.

Should your child’s cast get wet, call your orthopedic office immediately. The staff will get you in and replace the cast with a new one once the skin has dried. If this happens after hours or on the weekend, staff at one of CHKD’s urgent care centers or the emergency department can remove your child’s wet cast and replace it with a splint. You should then call your orthopedic office to schedule an appointment for a replacement cast.

If there is any doubt about whether your child’s cast is wet, call the orthopedic office to schedule an appointment. It's always better to be safe than sorry. Making an extra trip to the doctor or urgent care is not ideal, but the risks of staying in a wet cast are far too great. If it's not taken care of, you and your child could be dealing with "a fungus among us!"

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About CHKD Sports Medicine

About CHKD Sports Medicine  CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.