Purens Abigail Gavra Michaelson
University of Minnesota College of Veterinary Medicine, St. Paul, MN, United States.
Biological Resources Laboratory, University of Illinois at Chicago, Chicago, IL, United States.
Front Vet Sci. 2020 Aug 27;7:561. doi: 10.3389/fvets.2020.00561. eCollection 2020.
The COVID-19 pandemic has caused a widespread shortage of facemasks and other personal protective equipment in veterinary medicine without clear, research-based guidance on alternatives to FDA-certified disposable surgical masks. In the absence of detailed veterinary research, an in-depth review of the human medical literature was conducted to evaluate the viability of reusable, sterilizable cloth, medical textile, or other material alternatives that may be quickly manufactured and used by veterinarians. The results at the time of publication support the AVMA, CDC, and WHO recommendations to extend use, reuse, and resterilize facemasks before considering using a homemade facemask. Pending further research, or until and unless the FDA certifies a reusable homemade mask or design, the substitution of homemade masks for FDA-certified surgical masks should only be considered as a last resort. Most homemade masks are not suitable replacements for N95 FFRs. If a homemade facemask must be made, the following materials and testing guidelines are suggested: - densely woven cotton fabric (≥270 thread count), medical textile, or other impermeable, breathable material that can be laundered and resterilized- make pleated or fitted pocket style facemasks to maximize fit- make masks with two sets of ties, not elastics, to endure laundering and autoclaving- internal wire or fabric tape may be used to mold masks over the nose- filter material should be designed for use near mucus membranes, such as facial tissue or paper towel- if possible, fit test homemade masks against an FDA-certified surgical mask as a control- if higher filtration efficiency is required, test according to the FDA Enforcement Policy for Face Masks and Respirators During the Coronavirus Disease (COVID-19) Public Health Emergency- Maintain enough masks to change as frequently as one would change disposable surgical masks to maintain appropriate hygiene.
新冠疫情导致兽医学领域口罩及其他个人防护装备普遍短缺，且对于可替代美国食品药品监督管理局（FDA）认证的一次性外科口罩的产品，尚无基于研究的明确指导意见。在缺乏详细的兽医研究的情况下，对人类医学文献进行了深入审查，以评估可重复使用、可消毒的布制、医用纺织品或其他材料替代品的可行性，这些替代品可供兽医快速生产和使用。发布时的结果支持美国兽医协会（AVMA）、美国疾病控制与预防中心（CDC）和世界卫生组织（WHO）的建议，即在考虑使用自制口罩之前，应延长口罩的使用时间、进行重复使用和再次消毒。在有进一步研究之前，或者在FDA认证可重复使用的自制口罩或设计之前，将自制口罩替代FDA认证的外科口罩应仅作为最后的手段。大多数自制口罩并不适合替代N95过滤式面罩（FFR）。如果必须制作自制口罩，建议遵循以下材料和测试指南： - 紧密编织的棉布（每英寸经纬密度≥270根）、医用纺织品或其他可洗涤和再次消毒的不透水、透气材料 - 制作带褶皱或贴合口袋样式的口罩，以最大限度地贴合面部 - 制作带有两组系带而非松紧带的口罩，以耐受洗涤和高压灭菌 - 可使用内部金属丝或织物胶带使口罩贴合鼻子形状 - 过滤材料应设计用于靠近黏膜处使用，如面巾纸或纸巾 - 如果可能，将自制口罩与FDA认证的外科口罩进行贴合度测试作为对照 - 如果需要更高的过滤效率，根据FDA关于冠状病毒病（COVID-19）公共卫生紧急情况期间口罩和呼吸器的执法政策进行测试 - 准备足够数量的口罩，以便像更换一次性外科口罩一样频繁更换，以保持适当的卫生。
