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CAREGIVER INSTRUCTIONS FOR THE WEAR AND CARE OF THE 

CRANIAL REMOLDING ORTHOSIS

  

 

  1. Your child will eventually wear his/her orthosis 23 hours a day, but will need several days to adjust to wearing the orthosis.  Follow the schedule below to gradually increase the wearing time:


DAY
ON 
OFF 
NAP
NIGHT 
        1        
   1 hr      
   1 hr    
       No        
        No         
2
2 hrs 
1 hr 
No 
No 
 3
4 hrs 
1hr 
Yes 
Yes 
 4
8 hrs 
1 hr 
Yes 
Yes 
 5
23 hrs 
1 hr 
Yes 
Yes 
 
  1. This cycle is repeated throughout the day, giving slight breaks for hot weather, or messy food that can soil the band.  The fifth day is considered a full time wear and the orthosis should only be removed for one hour during bath time.  The orthosis should not be worn during bath or in the pool.  If your therapist or physician has given you neck exercises to perform, remove the orthosis for the exercises and replace it as soon as the exercises are finished.
  2. At bath time each day, remove and clean the orthosis.  Use only rubbing alcohol to clean the orthosis because other products may be harmful to the child's sensitive skin.  Vigorously rub the inside of the orthosis with a washcloth containing the rubbing alcohol or by applying rubbing alcohol to a new soft toothbrush  Set the orthosis upside to dry and weather permitting, place the orthosis in the sun to dry.  Shampoo the child's head daily, and reapply the orthisis when both the head and the orthosis are dry.  Some children have very sensitive scalps and may benefit from a mild hypoallergenic or herbal shampoo.  The orthosis should not get wet, and should be removed for swimming.  After swimming wash your child's head with shampoo to remove chlorine, sunscreen, etc. Reapply the orthosis when both your child's hair and the orthosis are dry.
  3. For the first several days, your child may perspire excessively until his/her body becomes accustomed to the orthosis.  During this time, the orthosis can be removed throughout the day to dry the child’s head and band. However, the orthosis should be immediately put back on the child’s head afterwards.  Do not use powders or lotions on the head or in the orthosis. If a heat rash appears at the base of the skull, apply hydrocortisone cream (Cortald) sparingly to the irritated area once a day after bathing.  This cream is available over the counter.  Aveeno has a shampoo that is gentle and can provide relief from the itching and skin rash.
  4. Skin checks should be performed each time the orthosis is removed.  Call your orthotist immediately if there is an area of deep redness that does not fade in one hour after removal of the orthosis.  This may indicate a need for an adjustment.  If there is any skin breakdown, remove the orthosis and contact your orthotist.
  5. It is important that all childcare providers understand how to apply, remove and care for your child in the orthosis.  Take a few moments to talk to them about the orthosis so they are comfortable being with your child and can provide the best care possible.
  6. The orthosis must be worm 23 hours a day to constrain undesirable growth and encourage growth in the correct locations.  Even at the end of treatment, the orthosis should be worn 23 hours a day until treatment is stopped.  There are a few times when it is acceptable to remove the orthosis.  These are: when the child has high fever, flu, day surgery, bath time, and when swimming.  Recasting may be necessary if the orthosis is not worn for an extended period of time

 

 

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