What is the treatment for a cement chemical burn?

Treatment for Cement Chemical Burns

Immediately irrigate the affected skin with copious running water for at least 15 minutes—this is the single most critical intervention to prevent full-thickness burns and must begin without any delay. 1, 2

Immediate Decontamination (First Priority)

• Begin water irrigation immediately at the scene of exposure, as even minutes of delay significantly increases the depth of tissue injury and hospital stay 1, 3
• Irrigate with large volumes of clean running water for a minimum of 15 minutes, though longer irrigation (up to 20-40 minutes) may be beneficial for cement burns given their alkaline nature 1, 2
• Remove all contaminated clothing, jewelry, and surrounding materials before they trap cement against the skin during decontamination 1, 2
• For dry cement powder, brush off as much as possible before water irrigation to minimize the exothermic reaction when water contacts cement 1
• Do not delay irrigation to search for specialized decontamination solutions—water is immediately available and effective 1, 2

The evidence strongly supports that immediate irrigation within 10 minutes with large water volumes decreases full-thickness burns, total number of burns, and mean hospital length of stay compared to delayed treatment 1, 3. Cement contains calcium hydroxide, a corrosive alkali that causes progressive deep chemical burns with prolonged contact 4.

Post-Decontamination Assessment

• Assess burn depth: cement typically causes deep partial-thickness or full-thickness burns due to its alkaline pH and prolonged contact time 4
• Evaluate total body surface area (TBSA) involved to determine disposition 2, 5
• Examine for signs of compartment syndrome if burns are circumferential on extremities 1
• Document the duration of cement exposure and time to irrigation 3

Wound Care Based on Burn Depth

For partial-thickness cement burns:

• Clean the wound with tap water, isotonic saline, or antiseptic solution 2, 5
• Apply petrolatum-based antibiotic ointment (such as polymyxin) 1, 2
• Cover with a clean, non-adherent dressing 1, 2
• Re-evaluate dressings daily for signs of infection or progression 2

For full-thickness cement burns:

• Cover with a clean, dry, non-adherent dressing 2
• All full-thickness cement burns require immediate evaluation by burn surgery for consideration of early excision and skin grafting 2, 4
• Early surgical excision with immediate skin grafting significantly reduces hospitalization time and returns patients to function sooner than waiting for eschar separation 4

Pain Management

• Administer over-the-counter analgesics (acetaminophen or NSAIDs) for mild to moderate pain 1, 2
• For severe pain, use short-acting opioids or ketamine, which are most effective for burn-induced pain 2, 5
• Consider general anesthesia for highly painful wound care procedures or extensive injuries 2, 5
• Non-pharmacological measures such as appropriate dressing coverage can reduce pain 5, 6

Mandatory Emergency Medical Services Activation

Call EMS immediately if any of the following are present:

• Burns involving the face, hands, feet, or genitals 1, 2, 5
• Partial-thickness burns covering >10% TBSA in adults or >5% in children 1, 2, 5
• Any full-thickness burns 1, 2
• Respiratory symptoms or signs of inhalation injury 1
• Systemic symptoms suggesting absorption 1
• Large surface area exposures 1

Critical Pitfalls to Avoid

• Do not delay irrigation for any reason—concentrated alkali from cement causes significant injury even with immediate treatment 1, 2
• Do not apply ice directly to cement burns, as this causes additional tissue damage through ischemia 2, 6
• Do not apply butter, oil, or home remedies, which increase infection risk and delay healing 2, 6
• Do not use external cooling devices for prolonged periods due to hypothermia risk 2, 5
• Do not routinely administer systemic antibiotic prophylaxis—reserve topical antibiotics only for infected wounds to prevent antimicrobial resistance 2, 5, 6
• Do not underestimate cement burns—they often appear deceptively minor initially but progress to deep full-thickness injury over hours to days 7, 4

Additional Considerations

• Consult regional poison centers for chemical-specific guidance on irrigation duration and additional treatments 1, 2
• Review Safety Data Sheets for the specific cement product involved 1, 2
• Monitor for signs of infection including increasing pain, redness, swelling, or purulent discharge 5
• For high-pressure cement injection injuries, immediate surgical debridement is mandatory for decompression and removal of cement to minimize chemical burn and tissue destruction 8