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Safe Cast Removal: Cast Saw Technique & Safety

Safe removal of a fiberglass cast requires correct oscillating saw technique, planned cut lines, skin protection, and clear patient communication. This guide covers tool setup, bivalving, use of a cast spreader, handling padding/edge tape, heat and vibration control, and post-removal care.


Proper cast saw positioning—perpendicular contact with guard and PPE during fiberglass cast removal

1) Setup & safety

  • PPE: thin non-latex gloves, eye/face protection; hearing protection in busy settings. Offer earplugs for children.
  • Tools: clean oscillating saw, cast spreader, padding scissors/cutter, dust extraction.
  • Patient briefing: the blade vibrates and doesn’t spin; short, vertical touches are safe; avoid sudden limb movement.
  • Positioning: stabilize the limb; plan cut lines away from prominences, tendons, scars.

2) Saw fundamentals

  • Angle & contact: blade perpendicular (~90°). Use brief 1–2 s “tap-lift” contacts to allow cooling.
  • Depth control: gentle pressure; a slight “catch” sound indicates reaching padding. Do not plunge continuously.
  • Heat: stop if the patient feels warmth/burning; allow cooling and ventilation.
  • Dust: use suction and orient cuts away from the team/patient face.

Planned bivalve cut lines: two longitudinal cuts safely away from bony prominences and neurovascular paths

3) Bivalving & spreader

  1. Cut plan: draw two longitudinal cuts on safe corridors; shift slightly medial/lateral near prominences.
  2. First cut: use tap-lift vertical contacts until padding is reached; pause every 2–3 cm.
  3. Second cut: repeat on the opposite side to free the shell.
  4. Spreader: insert jaws and gently pry the shell open.
  5. Padding: cut padding with scissors; avoid aggressive pulling on skin.

4) Final removal & edge tapes

  • Release moleskin/edge tapes first to reduce adhesion.
  • For semi-rigid splints, one cut plus spreading may suffice.
  • Colored multi-layer casts retain heat—work patiently with more cooling pauses.

5) Pediatrics & anxious patients

  • Explain sound/vibration; let them touch the inactive blade.
  • Seat a parent/companion; use breathing/countdown techniques.
  • Shorter contacts, more pauses, and active suction.

6) Common errors & fixes

  • Over-plunging: risk to padding/skin—return to short vertical contacts.
  • Hot spots: pause, vent, re-approach in short bursts; check skin.
  • Cut over prominences: reroute to softer corridor; finish from the opposite side.

After cast removal: skin and padding check, CSM assessment, and gentle range-of-motion start

7) Post-removal care

  • Skin: cleanse with lukewarm water/mild soap; moisturizer on exposed skin.
  • CSM: reassess color/warmth/sensation/motion; abnormal findings → prompt review.
  • ROM: begin gentle exercises per provider’s plan; report atypical pain.
  • Red flags: escalating pain, numbness, blisters/ulcers, discharge, or foul odor—call the clinic.

Conclusion & CTA

Using short perpendicular contacts, planned bivalving, proper use of a spreader, and thoughtful post-care allows safe, skin-friendly cast removal. For staff training or case-specific advice, please contact our team.