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Looking after your back slab

Information for patients from Accident and Emergency (A&E) and the
Minor Injury Units (MIU)

You have been placed into a type of cast called a back slab. This leaflet outlines/explains how you
are to look after your back slab.

Why have I been fitted with a back slab?

When you fracture (break) a bone, you will experience swelling around your fracture which may
continue along the whole of the affected limb. Back slabs have a gap in them which allows for this

How long will I have the back slab?

This type of cast is used until you attend your fracture clinic appointment. Ensure you have a
fracture clinic appointment before you leave. Unfortunately this does vary from patient to patient,
type of injury, and availability of fracture clinics. However, it is expected that patients are seen
within two weeks.

How do I look after my back slab?

Keep it high
• The affected limb must be kept elevated, ideally above heart level. Legs in casts must be kept
higher than the hip, at least when resting.
• You may be supplied with a sling – wear this as little as possible but keep your hand elevated
above your heart as much as possible; you can rest your hand on your shoulder, or sit with it on

Keep it dry
• Your back slab will remain wet for 24/48 hours.
• Your back slab must be kept dry!
• Do not use carrier bags, bin bags, or cling film to cover your back slab. They leak and cause
your skin to perspire (sweat) under the cast, causing your skin to breakdown.
• Cast covers may be purchased online or you can buy them in large supermarkets and large
pharmacies (speak to a member of staff for further information). If you do not get a cover,
simply keep your cast out of the water and cover it with a large towel.
• For lower limb injuries, it is safer to strip wash and cover the back slab with a large towel.

1 Looking after your back slab (December 2017)

Keep it moving
• Exercise all your joints not held in your back slab to prevent unnecessary stiffness and swelling.
• If your leg is in plaster, get up and hop about for a few minutes every half an hour on your
crutches/zimmer frame (only if safe to do so).
• Do not walk on your back slab – they are not strong enough to support walking.

How can I help prevent blood clots and deep vein thrombosis (DVT)?
If you have your leg in a fixed position you should be assessed for your risk of blood clots in the
legs (deep vein thrombosis or DVT) and lungs (pulmonary embolism or PE). Ask for a copy of the
Reducing the risk of a blood clot for patients with plaster casts leaflet if you have not been
given one.

You can help prevent blood clots by:

• continuing to take any medication as prescribed to prevent blood clots; and

• moving around (mobilising) as instructed.

If you experience increased pain, swelling, or any other changes in either of your legs, go
immediately to your nearest accident and emergency (A&E) department (see contact numbers at
end of this leaflet).

If you experience any pains in your chest, shortness of breath, or any other chest problems
call 999 for an ambulance.

My back slab is itching, what should I do?

Do not push anything down your cast to scratch. This is very important because:
• this causes the wool to bunch up, creating a tourniquet which interferes with your circulation;
• you may cause a wound to your skin which could potentially become infected in the moist
environment of your back slab.

Your back slab should not itch if you keep it cool and dry. If it does itch, use one or all of the
• use the cold setting on a hair dryer
• a hot water bottle with cold water in it
• a fan.

What not to do
• Do not use ice, as it melts it can cause your back slab to become wet.
• Do not wear rings on the fingers/toes of the affected limb due to the potential of swelling.
• Remove/do not wear nail varnish on the nails of the affected limb so you can keep an eye on
your circulation through the colour of your nail beds.
• Do not adjust/remove your back slab as you risk further injury or making your existing injury
• Do not drive while you have a back slab in situ – it is illegal and if caught you face an instant

2 Looking after your back slab (December 2017)

What if I experience any pain or discomfort?
If you experience any of the following problems, please return to A&E immediately for treatment.

• Burning, numbness, tingling pain, pins and needles.

• Pain in the fingers/toes on the slightest movement of the affected limb.
• Fingers/toes of the affected limb feel cool compared with the unaffected side.
• Fingers/toes of the affected side look dusky/waxy.
• Any seepage through the cast or sores/redness around the edges of your back slab.

What do I need to know about my fracture clinic appointment?

• Take painkillers before you attend the fracture clinic as removing/changing your back slab may
be uncomfortable.
• Wear loose/comfortable clothes so we can get to your back slab to change/remove it.
• Be prepared to be in the fracture clinic for a while – as well as seeing an orthopaedic surgeon,
you may also need to go to the plaster room and x-ray.

What if I have any questions or concerns?

If you have any questions before you attend your fracture clinic appointment please contact
A&E on the following:

• A&E, William Harvey Hospital, Ashford Telephone 01233 616728

• A&E, Queen Elizabeth the Queen Mother Hospital, Margate Telephone 01843 235030

If you need to discuss your back slab after this initial appointment, then please contact the
plaster room at:

• Queen Elizabeth the Queen Mother Hospital (QEQM), Margate Telephone: 01843 234316

• William Harvey Hospital, Ashford Telephone: 01233 616849

• Kent and Canterbury Hospital Telephone: 01227 866354

This leaflet has been produced with and for patients

If you would like this information in another language, audio, Braille, Easy
Read, or large print please ask a member of staff.

Any complaints, comments, concerns, or compliments please speak to your doctor or

nurse, or contact the Patient Advice and Liaison Service (PALS) on 01227 783145 or 01227
864314, or email

Further patient leaflets are available via the East Kent Hospitals web site

Information produced by the Fracture Clinic

Date reviewed: December 2017 Next review date: March 2020 Web 331
3 Looking after your back slab (December 2017)