Cast Removal: What to Expect

Once it’s time for cast removal, a healthcare provider uses a cast saw to cut through the plaster or fiberglass the cast is made of. It may seem scary to have this tool so close to your skin, but cast removal is safe when done by a qualified healthcare provider.

This article explains how a cast saw works, how safe cast removal is, and what you can do to make the process go as smooth as possible.

How a Cast Saw Works

Cast saws have a sharp, small-toothed blade that rapidly vibrates back and forth. It does not spin around like a circular saw. Against the firm surface of the plaster or fiberglass, the cast saw will cut through the material. However, against your skin, the cast saw simply moves the skin back and forth with the vibration, not cutting into the skin. 

Newer cast saws have become even easier to tolerate during cast removal. The most significant difference is the noise coming from the motor of the saw. Older cast saws tend to have very noisy motors that can be frightening, especially for children. Newer saws have much quieter motors that cause much less anxiety for patients.

The Safety of Cast Saws

Cast saws are very safe, but they should only be used by personnel who have been trained in their proper use and how to avoid problems. Improper use of a cast saw, or use of a cast saw that has worn blades, can cause problems.

While uncommon, some cast saw complications can occur during cast removal, including a small skin injury or burn. However, with proper use, these injuries are not common, and there are precautions that can be taken to minimize this risk.

What Can Go Wrong?

There are a few problems that can occur with the use of a cast saw, and it is important that the device is used by someone knowledgeable with proper cast saw techniques. While a healthcare provider should know proper cast saw techniques, many cast techs, physician assistants, and medical assistants are also qualified in using this device.

The most common reasons people had complications during cast removal, according to one study, were worn-out blades, insufficient cast padding, or improper training and experience. The rate of reported injuries from cast saws ranges from well under 1% to around 4%; therefore, the risk is small, but not nonexistent. The most common problems include the following.

• Burns: Skin burns are the most common problem that can occur when removing a cast with a cast saw. Because of the vibration of the cast saw blade, high temperatures can result from the friction of the blade against the cast material. If the blade heats up and contacts the skin, a burn can occur. Using less pressure on the saw to prevent heating of the blade, and allowing a warm blade to cool, can help prevent this problem. Temperatures have been shown to be higher when cutting through fiberglass cast material as compared to plaster.
• Cuts: Small skin lacerations are uncommon, but can occur. The teeth of the cast saw blade can be sharp enough to scratch the skin. If ample padding is under the hard cast material, a skin laceration is less likely.

If you think you have sustained an injury as a result of cast removal, let your healthcare provider know. Abrasions and burns can be better managed when your provider is aware that these may have occurred.

Preparing for Cast Removal

Many people, especially younger children, are frightened of cast saws, but there are measures that can be taken to make the experience less traumatic.

• Explain what is happening. Don’t let the healthcare provider or cast tech rush in and start removing the cast without showing the patient the equipment and how it works. Fear of the unknown is usually much worse than fear of the saw.
• Show how the saw will not cut the skin. Skin lacerations are the most common fear, and demonstrating that the saw will not cut your skin can help. Your healthcare provider or technician may press the blade of the running cast saw against their hand to demonstrate that it’s safe.
• Bring headphones. A cast saw can be noisy, and often the noise is more upsetting than the actual feeling of the saw. Earmuffs, headphones, or a noise-canceling device can help. Often kids will enjoy listening to music during cast removal.

A Word From Verywell

Casts are commonly used for treatment in orthopedics. Many people, at some point or another in their life, will have a cast placed for treatment of a broken bone or immobilization after surgery.

While cast removal can provoke anxiety, it is actually a very safe procedure. A skilled cast technician will take steps to ensure that your cast is removed safely and without complications.