Cement burn
Background
- Widely used in construction, under recognized as a caustic agent able to cause severe skin injury
- Calcium hydroxide very strong corrosive alkali
- pH of 10-12 that can increase to pH 14 during hydrolysis/setting process
Clinical Features
- Most often on lower legs/knees given nature of work
- Kneeling down in cement, walking in cement without protection, spilling over top of work boots
- Symptom onset several hours after exposure - may not start to feel until 3-4 hours after initial exposure
- Can have partial to full thickness burn
Differential Diagnosis
- Lye Burn
Caustic Burns
- Caustic ingestion
- Caustic eye exposure (Caustic keratoconjunctivitis)
- Caustic dermal burn
- Airbag-related burns
- Hydrofluoric acid
- Tar burn
- Cement burn
Evaluation
- Causes a liquefactive necrosis via protein denaturation (not a thermal burn)
Management
- Copious water irrigation for at least 30 mins
- May cause circumferential burns
- Counsel about skin protection in future if occupational
Disposition
- As can look benign in first few hours, admission, may need burn center if full thickness, circumferential, involving feet
Burn Center Transfer Criteria[1]
- Partial thickness >20% BSA (10-50 years old)
- Partial thickness >10% BSA (<10 or > 50 yrs old)
- Full thickness >5% BSA (any age)
- Burns involving face, eyes, ears, genitalia, joints, hands, feet
- Burns with inhalation injury
- High voltage electrical burn
- Chemical burns
- Burns complicated by fracture or other trauma (in which burn is main cause of morbidity)
- Burns in high-risk patients
See Also
External Links
References
- Spoo J, Elsner P. Cement burns: a review 1960-2000. Contact Dermatitis 2001; 45:68.