Spica Cast Care

Spica Cast Care Instructions

Spica cast is a half-body cast. It is often placed on a child’s hips, legs, thighs, and abdomen to allow bones, joints, and tendons to heal.

How to care for your child’s cast

  • Keep the cast clean and dry. When your child is eating, cover the cast with a bib or towel.
  • If the outside of the cast gets dirty, wash it with soap and a damp cloth. Then allow it to air-dry.
  • Have your child wear loose clothing over the cast.
  • Check the cast every day for cracks and other changes in the cast.
  • Do not allow your child to stick anything inside the cast. Doing that increases the risk of infection.

How to care for your child’s skin

  • For the first 3–4 hours after the cast is put on, check your child’s toes. Make sure:
    • The toes are pinkish and warm.
    • The toes are not swollen.
    • Your child can wiggle his or her toes.
    • Your child can feel your touch.
  • Every day that the cast is on:
    • Make sure there is the same amount of space between the cast and skin as there was when the cast was put on.
    • Check your child’s skin in bright light. Check for reddish areas near the edges of the cast. Feel around for sores.
  • Put rubbing alcohol or a solution prescribed by your health care provider on the skin near the edges of the cast. Do this 2–3 times a day or as told. This will help toughen the skin. Stop if the skin becomes too dry or cracked.
  • You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
  • If your child’s skin itches or feels hot, you may blow cool air into the cast with a hair dryer on the lowest setting.

How to move and position your child

  • Your child should not stand or walk in the cast unless your health care provider says it is okay.
  • You may use a reclining wheelchair to move your child. Wheelchairs are available at hospital or medical supply stores.
  • Pick up your child by supporting the cast, the leg area, and the upper body:
    • When picking up your child, put one arm under the bottom of the cast and your other arm under the child’s opposite arm.
    • You may use the abduction bar to help you carry or lift the child.
    • Do not pick up your child by the armpits.
  • Keep your child’s head and upper body raised (elevated) at all times.
  • Change your child’s position every 2–4 hours.
  • You may use pillows to prop up your child in a stroller, but make sure to use the safety belt.

Using the bathroom

Older children

  • Your child may use a bedpan or toilet to go to the bathroom.
  • Your child should be sure to wipe and dry the buttocks well.

Younger children

  • Use disposable diapers and one-piece garments that snap at the crotch if possible. The diapers should be small enough to tuck under the cast in both the front and back of the cast. It is okay to place the child on his or her abdomen to tuck the diaper under the back of the cast.
  • At night, consider using nighttime diapers or putting a sanitary pad in your child’s diaper.
  • You may put a larger diaper outside the small, inner diaper and over the spica cast for protective purposes.
  • You may use an elastic belt to keep a diaper in place.
  • Change diapers regularly to keep the cast from getting dirty.

How to petal a cast

Petaling a cast means lining the edges of the cast with soft, smooth, waterproof tape or moleskin to protect the skin. If your child’s health care provider tells you to petal the cast, follow these steps for each edge of the cast or opening in the cast:

  1. Cut 4-inch strips of tape or moleskin.
  2. Stick one end of the strip under the edge of the cast onto the cotton liner.
  3. Fold over the rest of the strip and stick it onto the outside of the cast.
  4. Continue this process by overlapping strips to make a sealed edge.

Contact a health care provider if:

  • Your child has pain that is not relieved by medicine or by elevating the head or upper body.
  • Your child has persistent itchy feelings under the cast.
  • Your child complains of burning or soreness under the cast.
  • You notice a bad smell coming from the cast.
  • You notice staining on the cast.
  • You notice skin changes near the edges of the cast, such as redness, cracking, or sores.
  • An object gets stuck in the cast.
  • Your child’s cast seems too tight or too loose.
  • Your child’s cast breaks, splits, or starts to fall apart.
  • Your child has an unexplained fever or fussiness.

Get help right away if:

  • Your child’s toes are cold, blue, or pale.
  • The color of your child’s toes does not change after you gently pinch them.
  • Your child’s toes are numb.
  • Your child’s toes or lower leg are swollen and very painful.
  • Your child is complaining of increasing pain in the cast area.
  • Your baby continues to cry as if in pain and cannot be comforted.
  • There is drainage coming from the cast.

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