Hello List. I received many responses from practitioners to my question about effective techniques for moulding TLSO’s over carved foam models. Here are the most common response:
1. We use foam blanks from OKM.
Our layup is as follows:
2 layers of Tubifast which we wet and then wring out as much excess moisture as possible https://urldefense.proofpoint.com/v2/url?u=https-3A__www.molnlycke.us_products-2Dsolutions_tubifast_&d=DwIF-g&c=sJ6xIWYx-zLMB3EPkvcnVg&r=KmuawjwNpT9A2bnhzaNVjw8wO7L_TDosEXIk33h_tlw&m=HuBAob5wZm9gcPpyhXohVHWRuphdcopr0V9Ut3GQc44&s=g2aARdqR8XPIvF6KE4nJl11oQ5J1NTj0VUMzQ95bF4M&e=
We then mould our plastics directly over this. Nil issues with shrinkage or nylon sticking and a nice smooth finish. Bleed the suction off to 20psi on larger models/thicker plastics after a vacuum seal gained/excess plastic trimmed if you are having trouble with nylon sticking.
2. We have been moulding over foam carvings for a couple of years
with great results – no TLSOs though!! After a few months of trials this
is how we do it – no shrinkage / no spreading – just exact fitting moulds!
– 1 x nylon stocking over carving (dry)
– 2 x DAMP Otto Bock COTTON Stockinette (623T1= ) – This is the only
stockinette that we have found that works well – you must use this!!!
– 1 x feather stretch (dry)
The trick is to let the moisture leave the cotton stockinette so it is just
damp to the touch – – never wet.
Pull your plastic – get a good vacuum – as soon as the plastic starts to
change colour (cool) turn off the vacuum and remove – this is important –
leave overnight and then cut off as normal.
3. What we have done is put a thin coating of plaster over the foam model, buff this smooth with some stockinette, put two layers of thin stockinette over the cast and pull 1/8″ co-poly over this as our definitive brace.
We have also tried a few techniques:
4. Wrap model in cling-wrap, apply 1-layer featherstretch nylon, mould 3 mm polyprop to seal model, cut off top and bottom ends of plastic, apply 1-layer featherstretch and mould definitive brace. Oven temp. 200 C. Both layers of plastic are cut off the model and edges finished before separating the two layers of plastic. Don’t cut any “windows” in the brace until both layers of plastic are separated. This method gave us the best finish, inside and out, of the TLSO, with no shrinkage. It also worked well with our TLSO design, which is like the Rigo-Cheneau with anterior overlap.
5. We had heard a recommendation that oven temperature be kept below 180°C when moulding over foam. While polypro will eventually cook at this temperature, it takes much longer, and the sheets of plastic required for a TLSO are so large that we found the edges never sufficiently ‘cooked.’ A lower oven temperature is not recommended, in our experience.
We tried to get as close as we could to attempting the list serv responses 1 and 2. The difference is that we used accucast instead of tubifast or Otto Bock stockinette, because we didn’t have those kinds of stockinette. The result was a good, useable product.
I hope this information is helpful. Please contact me if you have any questions.
Rajiv Kalsi, C.O.(c)
Certified Orthotist, Prosthetics/Orthotics Service
Orthésiste Certifié, Service de prothèses et d’orthèses
The Ottawa Hospital Rehabilitation Centre
Centre de réadaptation de l’Hôpital d’Ottawa
505, ch. Smyth Road, Ottawa ON K1H 8M2
T: 613-737-7350, 75314 | F: 613-523-1571
rkalsi@toh.ca
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