Effectiveness of Ice Packs in Reducing Skin Temperature Under Casts

Division of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, CA, USA.
Clinical Orthopaedics and Related Research (Impact Factor: 2.77). 10/1996; 330(330):217-21. DOI: 10.1097/00003086-199609000-00029
Source: PubMed


Skin temperature lowering effects were measured after application of crushed ice packs to the surface of synthetic and plaster casts. The skin temperature of legs in synthetic casts decreased an average of 10.4 degrees C (range, 8.3 degrees-12.6 degrees) to a minimum temperature of 19.7 degrees C (range, 16.2 degrees-21.8 degrees), and the temperature of legs in plaster casts decreased an average of 11 degrees C to a minimum of 18.7 degrees C (range, 13 degrees-22.8 degrees). It took an average of 56 minutes (range, 40-80 minutes) for the legs in synthetic casts and 63.8 minutes (range, 26-116 minutes) for the legs in plaster casts to reach the minimum temperature. Cryotherapy is used clinically with the intention of lowering skin temperature and presumably decreasing the pain and swelling of a patient's injured extremity. The presence of a synthetic or a plaster cast does not eliminate the lowering effects of skin temperature when crushed ice packs are applied to the surface of the casts.

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    • "Pour limiter les risques, il convient notamment d'éviter la mise en place d'un coussin sous le membre, empêchant le dégagement de chaleur. Certains auteurs (Metzman et al., 1996 ; Weresh et al., 1996) proposent d'utiliser des packs de glaçons après confection de l'immobilisation. "
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    ABSTRACT: th century. Until recently, osteoarticular trauma has been treated mostly by plaster cast immobilisa- tion using plaster of Paris. Synthetic materials have been introduced on the market place in the seventies, but they have not superseded the traditional plaster of Paris. The more recent thermoplastic materials are used to make splints and orthoses, particularly at the wrist and hand. The present review of the litera- ture confirms that synthetic materials present better physical and mechanical properties than the tradi- tional plaster of Paris. In addition, they are lighter, they are more resistant to humidity, they are more radiotransparent and they generate less dust when removed. However, they are less malleable and cause higher pressure in case of limb edema. Plaster of Paris therefore remains indicated in the acute post- traumatic or postoperative period. This material is also cheaper, but the pecuniary benefit is limited for several reasons, particularly because plaster of Paris is associated with a higher rate of cast replacement.
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    ABSTRACT: There is a general belief that the presence of a cast or a bandage eliminates the lowering effects of skin temperature when local cold therapy applied on the surface of the cast or bandage. The purpose of this study is to determine the magnitude of temperature changes at the skin of the ankle after the application of frozen ice packs to the surface of various casts and bandages both in normal and swollen ankles. Thirty-two healthy subjects (Group A) and 12 patients with Grade III inversion type acute ankle sprain (Group B) were randomly divided into four groups. The sensor of the digital thermometer was secured to the ankle over the anterior talo-fibular ligament in every subject before placement of a bandage or cast. Robert Jones bandage, elastic support bandage, a below-knee plaster cast and synthetic below-knee cast were applied in groups 1, 2, 3 and 4, respectively. Two frozen ice packs were placed around the cast or bandage at the level of sensor, and skin temperatures were recorded. The skin temperature under dressings and casts decreased significantly relative to the baseline temperatures with local cold therapy in all groups. The fall in the temperature with cryotherapy in group A showed a three-phase pattern of change between groups 1 and 2, groups 2 and 3 and groups 2 and 4 during the experiment. The fall in the skin temperature with ice packs differed significantly between groups 1 and 3, and also groups 1 and 4 from the beginning till the end of the experiment. There was no significant difference between groups 3 and 4 in terms of skin temperature fall with cryotherapy during the whole experiment. The results were similar in group B. A bandage or cast does not prevent measurable skin temperature lowering by frozen ice packs both in normal and swollen ankles.
    Archives of Orthopaedic and Trauma Surgery 01/2007; 126(10):668-73. DOI:10.1007/s00402-006-0189-3 · 1.60 Impact Factor
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