Caregivers and Clinic Providers View Soft Casts for Pediatric Hand Burns as Acceptable and Feasible: A Mixed Methods Survey.

Abstract

Soft casts have been introduced as an efficacious strategy to manage hand burns that simplifies wound care for families. We hypothesized that the outpatient use of soft casts in pediatric hand burns would be viewed as acceptable by patient caregivers and providers, logistically feasible, and result in satisfactory clinical outcomes. A review was performed of pediatric clinic patients managed with soft casts since implementation (9/2022-9/2023). Patient caregivers and providers were surveyed. The primary outcome was the acceptability of soft casts as a management strategy (questions targeted care burden, overall satisfaction, comfort, pragmatism, and healing concerns). The secondary outcome was feasibility (effect on clinic workflow, and efficiency). Survey responses were collected from 70% of caregivers and 95% of providers. Responses overwhelmingly favored soft cast acceptability. Among providers, 84% agreed that "the soft cast method simplified the hand burn care experience in our clinic" and 100% indicated "the soft cast was easy for parents to manage at home" (Likert range 7-10, mode 10). Thirty-three English-speaking patients with partial and full-thickness hand burns were managed with soft casts. A mean of 1.8 reapplications (mode 1, range 1-5) was required with a median healing time of 13 days. No infections were attributed to the use of soft casting, and only 1 patient ultimately required grafting. Overall, the introduction of soft casts as a management strategy for pediatric hand burns was acceptable and feasible. The clinical outcomes assessed suggest soft casts are associated with good wound healing with minimal wound care responsibilities for patients and families.