Cast precautions In Hip Spica

These guidelines are also the general care guidelines for children wearing a hip spica:

Please follow all instructions given to you at the time of discharge.

General care instructions for a hip spica:

• The hip spica should not get wet. Usual cause of a wet spica is leaking of urine into the hip spica.
• When washing hair or upper body, do not allow water to enter the cast
• You can also wet sponge clean the baby’s trunk area to avoid the cast getting wet.
• Do not insert any object into the cast. It can remain inside and will cause a sore (An infected wound).
• Make sure that the baby does not insert any objects into the cast.
• Do not scratch inside the cast. Deep scratches can get infected.
• Give frequent small meals when in hip spica. Large meals should be avoided.
• Do not pour a lot of talcum powder into the hip spica. It will cake up inside and can cause a local infection

To avoid wetting the cast with urine:

• Correct size diaper (Usual brand name - Huggies) must be used.
• Change the diaper when wet
• Do not stuff the diaper into the hip spica. That will deliver the urine into the hip spica if diaper gets fully soaked
• Raise the head end of the bed so that the baby’s bed has a downward slope towards the foot end. This will encourage the urine to flow down and away from the hip spica.
• If the lining of the hip spica gets wet; Blow dry the wet areas with a hair dryer using cold air. It is very important to keep the heating switch in off position. The baby’s skin can be damaged from hot air, and the child will suffer burns.
• A wet spica liner promotes contact dermatitis. The skin of the baby can become red, ulcerated, and infected if the wetness is allowed to persist.
• To avoid contact dermatitis, a parent can regularly apply RASH-FREE cream to area under the diaper.

Frequently change position of the baby

• Position is changed from supine to prone, and vice-e-versa.
• This would have been taught in the hospital and must be followed at home every 2-3 hours.
• When the baby is prone, back care can be given.
• Inspect the back – look for a rash
• Look for any wetness in the plaster liner – dry it as described above.
• Look for any areas under pressure from the edge of the cast. The skin may be red, or the child may cry if there is pain from the plaster edge.

Inform us accordingly:

• A visit may be required to the hospital OPD to rectify these problems.
• Red Flags for a hip Spica
• The child is vomiting persistently. This happens a day or two after application of the cast. Inform your doctor immediately.
• Foul smell coming from the cast – indicates a skin infection
• Red rash on the cast edge or the diaper area. This is usually due to prolonged contact with urine. It is also called a diaper rash.
• Any persistent swelling of the feet indicating a tight cast.
• Any Blue discolouration or white discolouration of the feet accompanied by incessant crying.

Inform us immediately if any red flag signs are evident.