Cement burn

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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

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.