Tip of the Week: Casting material – what to get and where

The best plaster casting material I have found that anyone can purchase online is the brand Gypsona, available through Amazon and elsewhere.  For adult-size arm splints and casts, 3″ plaster rolls are appropriate.  For adult-size leg splints and casts, 4″ rolls are needed.

For children, these larger rolls can be cut to yield the correct width.  Generally speaking, the appropriate roll-width is approximately equal to the width of the palm; for legs the width should be a little more than the widest part of the foot.   You will also need to purchase cast padding (synthetic is less expensive than cotton) and 3″ and/or 4″ stockinette.

When buying online you generally will have to buy in bulk, that is, a case of 12 rolls at a time.  At my Survival Medicine classes I offer them individually.   (I may begin offering these supplies on this site, so check back soon.)

About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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6 Responses to Tip of the Week: Casting material – what to get and where

  1. Mark says:

    What about the really old fashioned way… Stockinette , Webril, roller gauze and boxed plaster of paris?

    Or if swelling is still likely, (or very bad sprains/strains) a short term webri/ace “soft” cast?

    • pa4ortho says:

      yes you can impregnate gauze with plaster of paris powder and make a plaster splint as an improvised splint. A angled board and a catch basin below it to recover the excess is a good way to do this. Keep in mind I read about the above from a report from India yrs ago. I never did it myself.

      Gypsona is cheap. Has a very long shelf life.

      You can use stockinete, webroll, plaster and an Ace wrap. works well, its common practice.
      I like the short cut of putting thewebroll padding on both sides of the plaster splint directly and wrapping with elastic bandage of gauze strips. This bypases the need for stockinette, also by padding the outside of the plaster with a layer of webroll as well the elastic wrap does not stick to plaster and can be reused. It takes less webroll as well.
      Less supplies = less cost and a smaller rucksack= good

      pa4ortho

  2. pa4ortho says:

    resin / fiberglass based products:
    Disadvantages- About 1 yr shelf life, less than that in a rucksack, about 1-2 hrs after the first pin hole in the foil wrapper.
    High cost compared to super cheap plaster, does not mold as well as plaster,
    Advantages- stronger, more forgiving of fat inexperienced fingers that can make dents leading to pressure ulcers, lighter, more tolerant to light water/weather contact,

    plaster / gypsum based products:
    Disadvantages- Heavy, turns to mush with water contact, easy to dent when applying, needs to be thicker to get same strength making removal harder (unless you soak it!) takes a lot longer to dry and harden especially in big thick leg casts.
    Advantages- very cheap, can be improvised from other materials, molds control of unstable reduced fractures well in experienced hands

    Best of both worlds: apply plaster and over wrap with epoxy paint after the plaster is very dry a few days later or wrap with a single roll of fiberglass.

    remember many Fx can be managed well with only a splint. don’t cast if it can swell, always be prepared to remove a cast,

    water proof cast padding is expensive but may add resiliency to a cast in a austere setting. to improvise Take synthetic cast pad and apply water proof spray alow it to dry and then apply,

    in my US based ortho practice I use resin splints and resin casts, for unstable fx I use plaster. We buy lots and it sits for less than 3 mo on the shelf.

    I only store plaster for prep purposes and austere med trips because of its long shelf life and low cost, 4 inch rolls can be used to build anything. however 6 inch rolls can be torn into 3 inch rolls length wise to construct anything. easily.

    you also need 4 inch synthetic cast pad. you can get cotton pad but it gets wet easily, traditionally cotton is used with plaster but synthetic works fine.

    to make those nice rolled edges on casts you need tubular stocking materials that extend past the pad, wrap pad, then apply a thin layer of plaster then roll back the tubular stocking apply more plaster.

    to make splints measure the length you need lay approximately 4 layers of padding slightly longer, then unroll and make layers 6 deep of plaster the exact length you want, wet this in cold water if you want a slow set as you are inexperienced and have lots of time, warm if you want it to set faster, hot water if you are a cast ninja and can move fast, make a peace sign pinch the hanging wet plaster materiel between the extended two fingers and strip the water out and mash the layers together fusing the plaster. lay it on the padding. next lay one layer of padding on top of the plaster so the elastic wrap does not stick to the plaster when you want to remove it. apply the splint wrap with ace wrap and mold it.

    if you don’t have ace wrap use strips of bed sheet 4 in wide.

    hope this helps pa4ortho

  3. Greg says:

    The Fiberglass casting material is good, however, it is difficult to store, after you open it. Back in the the day, the length of Fiberglass was shipped from the manufacture, in a flat mylar tube roll sealed on both ends and was about 10-15 feet long. Once you open the end by cutting with a pair of scissors, they supplied you with a giant “Chip Clip” to re seal it. The Clip works to try and seal off any air getting into the remaining product in the bag but never really did a good job.

    IF and only IF you were doing cast after cast after cast would I ever consider buying it. It has a tendency to dry out and be worthless to ever consider storing for preps. I taught casting and splinting in level II trauma center for a short period of 10 years back in the day. Maybe someone that has more recent experience with newer packaging can chime in here.

  4. irontomflint says:

    Is it possible to come to your class location just to pick up the medical supplies and maybe a signed copy of your book?
    I am saving for the class now but seeing as I am in the general area of Akron I (and others), could stop in and purchase supplies. Not all day long mind you, just set a time period either before or after the class when people could get what we need.
    Thanks!

    [I do have books available for sale at my office, but not medical supplies for sale. This winter I hope to be offering some 1-day workshops that local folk may want to attend. – Doc Cindy]

  5. Jeff B. says:

    Hi,

    Any thoughts, positive or negative, on using fiberglass casting material instead of more traditional plaster? I know it requires gloves for handling due to the resin. We already keep it in stock for making repairs to our daughter’s prosthetic leg, and had always though we’d use it for casting as well.
    Thank you for your help!

    -Jeff

    [Doc Cindy replies: Though I have not worked with fiberglass, I have discussed this question with those who do. The main problem is short shelf-life. I don’t have an exact time frame to give you, but others have said that within a couple years the material becomes unusable. Whether this could be improved with specific storage conditions I don’t know. But at one conference I attended, the presenter used 30-year-old plaster without any problems. You may want to experiment now while you have the chance. If you have any old material that has not degraded, I’d be interested in any comment you can offer.]

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