Muhammad Saleem, Imran Manzoor, Shaukat Rabbani.
Comparison between Water Resistance Padding and Synthetic Cotton Padding, regarding patient Comfort Level under the cast for fractures.
Pak J Med Health Sci Jan ;12(3):1170-2.

Aim: To establish which cast padding is more inline of comfort with patient’s daily routine activities with regards to odor , itching, sweating, ulceration of skin and bathing. One consists of ordinary synthetic cotton and other liner system consists of water resistant polypropylene , nylon and polyester fiber. Study design : Prospective Randomized clinical trial Setting : Department of Trauma and Orthopedics Shalamar Hospital, Lahore Methods : It was a Prospective Randomized clinical trial of 40 patients who visited our OPD of Department of Orthopedic , Shalamar Hospital, Lahore ranging from 18 to 60 years who had closed fracture of both upper and lower limb with minimal displacement during a period of 6 months , Aug 2017 to Jan 2018. Patients were divided into two groups of 20 patients in each group. One group had ordinary synthetic cotton lining and other had water-resistant Synthetic Cotton lining. Both were seen at one week , two weeks, four weeks and six weeks interval. Then cast was removed and patients were examined subjectively and objectively and were given questionnaire and then scoring was done according to Likert’s scoring scale of compliance regarding odor, sweating, itching, ulceration of skin and bathing. On the basis of scoring, conclusion was drawn as of which padding was more inline with satisfaction of patient and surgeon. Mean plus Std deviation was calculated for quantitative variables like age, sex, upper or lower limb fracture. Mean plus S. Daviation were calculated for qualitative variables. Data was stratified and post stratification table was generated to calculate score for odor , sweating, itching, ulceration of skin and difficulty in bathing using Likert scale ranging from 1 to 5 (1 = strongly dis agree 2= dis agree, 3= neutral, 4 =agree, 5= strongly agree ). Results: Water proof cast liner has better scores with regards to above mentioned parameters under study. Parameters Odor ( P= 0.000), Sweating ( P= 0.000) , Itching ( P=0.03 ), difficulty in bathing ( P=0.000 ) but 5th parameter , Ulceration of skin (P= cannot be calculated) did not show any significant difference between the two groups. Conclusions: Water resistant cast liner had better scores in four parameters of patient and surgeon satisfaction, and one parameter of surgeon satisfaction namely ulceration of skin did not show any significant difference between the two groups. The overall comfort level is significant more in patients who had water resistance cast padding for fractures and we strongly recommend to use this specially in hot weather.

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