Usual types of injury:
(1) thermal burn from overheated oscillating blade
(2) skin abrasions by the saw teeth
General risk factors:
(1) inadequate training
(2) suboptimal conditions (for example weekend night in the Emergency Department)
Risk factors for thermal burns:
(1) failure to use dust vacuum (air flow cools blade and removes heated debris)
(2) poor blade condition (dull, etc)
(3) failure to let an overheated blade cool (can be expedited by use of water or 70% isopropyl alcohol on gauze)
(4) continuous cutting with the blade never leaving the cast material
(5) thin padding
(6) too thick of a cast
(7) cutting in a concavity (as in a flexed elbow)
Risk factors for skin abrasions:
(1) thin padding
(2) cutting over a bony prominence
(3) pulling the skin taut while cutting
Using an "in and out" cut reduces any skin contact compared to dragging the blade in continuous cuts.