Table 2.

Comparison of modern-day immobilization material analyzed under the review.

Material	Description	Activation	Cast layers required (10 cm wide)	Setting time	Curing time	Time for load bearing (s)	**General weight of cast (g)	x-ray permeability	Cost/package ($)
Plaster of Paris bandages	Plaster of Paris impregnated leno weave fabric bandage with accelerators and binders.	Dip 10s in water at 20–25 °C	5-12 layers	4–8 min–30 min * 4–8 min for fast setting casts	24–48 h	48–60 h	>1000g	Radiopaque	$20	Rigid but brittle. Undergo water degradation and messy application. Suitable for long term immobilization.
Fiberglass - PU resin bandages	Polyurethane or PU resins impregnated fiberglass bandage	Dip water at 15–27 °C for 2–10s	3-6 layers	3–5 min	5–7 min	15–30 min	<500g	Radiolucent	$70-$89.	Rigid waterproof bandage, contains isocyanates which can cause occupational asthma due to high dust generation during removal. Used as a secondary cast material.
Plaster of Paris, Fiberglass hybrid	Plaster of Paris casting tape overlaid with Fiberglass-PU bandage	Respective activation for each plaster of Paris and fiberglass bandages	4 layers of plaster overlaid with 4 layers of fiberglass bandage	Respective set times for each material. Total cast takes ∼30 min	Respective set times for each material. Total cast takes ∼24 h	Respective set times for each material. Total cast takes ∼48 h	>500g Depends on the number of layers	Radiopaque plaster layers	10% cost reduction compared to a total fiberglass cast.	Hybrid casts uses the benefits of both plaster and fiberglass but not radiolucent due to radiopaque plaster layers.
Polyester-PU resin and other PU resin bandages	Polyurethane polymer impregnated open weave polyester bandage (most common) *bandage type can vary according to commercial product.	Cold water immersion	3-8 layers	3–5 min	∼30 min	20–30 min	∼650g	Radiolucent As they are weaker than fiberglass require more layers, hence attenuates more	$158	Polyester offers more elongation and good flexibility to the cast. Contains isocyanates and tacky resins. Should handle using lubricated gloves. Used as a secondary cast material.
Thermo-plastic	Thermoplastic impregnated polyester tape with inorganic fillers. (available as thermoplastic impregnated bandages and thermoplastic sheets)	Immerse in hot water at 70–85 °C for 1–5 min	3-5 layers (∼5 layers)	2–3 min	3–30 min	∼15–30 min	∼700g	Radiolucent but shadows and artefacts present	< $56	Low temperature setting thermoplastics are available to reduce thermal damage. Low weight bearing ability than fiberglass bandages.
RTV Silicone rubber	RTV Silicone rubber + medical gauze with added curing agents and catalysts	Applied onto medical gauze until desired thickness is obtained and cut using bandage scissors to form the splint	2-5 layers	1 h	2–4 h or 24 h. Depends on curing agent used	∼5–24 h	450–600g	Splints are removed during radiological assessments	$ 12 per can	Absorbs impact forces and offers high flexibility. Used in short term (<4 h) splinting of sport related injuries. Not suitable for longer term circumferential casting
Woodcast	Woodchips from Finnish Aspen or Spruce in Biodegradable thermoplastic polymer matrix	Heated to 62 °C	1 layer of 4 mm material	15–30 min when cooled at ambient temp (22 °C)	15 min	5–15 min	Lightweight material. Exact weight not provided.	Good radiological properties, cast almost invisible in x-ray images	$71-$ 180	Sustainable Wood-plastic composite with good radiographical properties and rigidity. Can be reheated. No toxic materials available.
Cellulose based cast material	Pyroxylin + Boric acid impregnated fabric wetted by acetone	Cellulose impregnated bandage wetted using a quick drying solvent at room temperature	∼3 layers	30–40 min	Prolonged curing time	TBA	Lighter than plaster bandages	Radiolucent	TBA	Waterproof lightweight material. Prolonged drying times exceeding 30mins. Adequate ventilation required for cast drying. High flammability and shrinkage.
RECAST	Bio-based Poly Lactic Acid (PLA) plastic	Heated to 55–65 °C	1 layers (thickness TBA)	After 3 min	TBA	TBA	TBA	Radiolucent, exact details not provided so far	TBA	Biodegradable sustainable material, to reduce the number of synthetic cast waste ending in landfills.

TBA- To Be Added.

*The table provides generalized details of the cast material, values provided can slightly alter depending on the commercial product and additives.

**Only generalized cast weights are provided, weights can differ according to the number of layers used.