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Here is the case.

A 48 year old man presents with some redness and burns on his lower limbs. He was using cement one day previously, laying a concrete slab and standing in it, his denim pants soaked. He felt some mild discomfort at the time, but now that he has seen his legs, he is concerned.

What do you think of his legs?

When I saw them I was concerned that the grey coloured ares I was seeing were necrosed and were full thickness burns……and they were.

Cement contains lime, which is Calcium Oxide. When it is exposed to moisture, it gives off an exothermic reaction. The hydrated calcium oxide becomes calcium hydroxide and the hydroxyl ion is what causes the skin damage.

If not removed from the skin, it can result in deep, painless necrosis and full thickness burns.

The initial first aid, should be copious irrigation. The use of a buffered solution for first aid is controversial.

The ultimate management for this patient was excision and grafting of his burns.

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