A stockinette is a seamless, knitted, tube-like fabric primarily used in orthopedic nursing to protect a patient's skin before the application of a plaster of Paris or synthetic cast. Because it stretches easily in the circumferential direction, it contours smoothly to various limb shapes without forming restrictive ridges or pressure points. Cotton stockinette allows for breathability, reducing moisture accumulation against the skin beneath rigid immobilization materials.
Stockinettes serve multiple critical functions in surgical and emergency settings:
Clinical stockinettes are manufactured from different fibers depending on the specific procedural requirements. Cotton stockinettes are standard for routine casting because they are gentle and absorbent. Synthetic stockinettes, often made from polyester or polypropylene, are sometimes utilized with waterproof cast padding systems because they do not retain liquid and dry rapidly after washing or bathing.
Proper sizing ensures the stockinette functions effectively without causing circulatory compromise. The nurse selects a tube width that matches the circumference of the limb—too large creates uncomfortable folds, while too small acts like a tourniquet.
Following cast or splint application over a stockinette, continuous monitoring is vital. Nurses assess neurovascular status regularly—checking pulse, pallor, pain, paresthesia, and paralysis. A common clinical error is assuming a stockinette prevents all pressure sores; if applied too tightly or allowed to bunch up, it contributes directly to compartment syndrome or skin necrosis.
Nurses must educate patients to keep the stockinette and cast clean and dry. Patients should be instructed never to insert foreign objects like coat hangers or knitting needles down the stockinette to scratch an itch, as this easily breaks the skin and introduces bacteria. Any foul odor, unusual burning sensation, or wetness emanating from beneath the stockinette must be reported immediately.