School of Health Sciences, University of Southampton, Southampton, UK.
University Hospital Southampton Foundation Trust, Southampton, UK.
Int Wound J. 2021 Jun;18(3):312-322. doi: 10.1111/iwj.13534. Epub 2021 Jan 28.
Since the outbreak of COVID-19 pandemic, clinicians have had to use personal protective equipment (PPE) for prolonged periods. This has been associated with detrimental effects, especially in relation to the skin health. The present study describes a comprehensive survey of healthcare workers (HCWs) to describe their experiences using PPE in managing COVID-19 patients, with a particular focus on adverse skin reactions. A 24-hour prevalence study and multi-centre prospective survey were designed to capture the impact of PPE on skin health of hospital staff. Questionnaires incorporated demographics of participants, PPE type, usage time, and removal frequency. Participants reported the nature and location of any corresponding adverse skin reactions. The prevalence study included all staff in intensive care from a single centre, while the prospective study used a convenience sample of staff from three acute care providers in the United Kingdom. A total of 108 staff were recruited into the prevalence study, while 307 HCWs from a variety of professional backgrounds and demographics participated in the prospective study. Various skin adverse reactions were reported for the prevalence study, with the bridge of the nose (69%) and ears (30%) being the most affected. Of the six adverse skin reactions recorded for the prospective study, the most common were redness blanching (33%), itchiness (22%), and pressure damage (12%). These occurred predominantly at the bridge of the nose and the ears. There were significant associations (P < .05) between the adverse skin reactions with both the average daily time of PPE usage and the frequency of PPE relief. The comprehensive study revealed that the use of PPE leads to an array of skin reactions at various facial locations of HCWs. Improvements in guidelines are required for PPE usage to protect skin health. In addition, modifications to PPE designs are required to accommodate a range of face shapes and appropriate materials to improve device safety.
自 COVID-19 大流行爆发以来，临床医生不得不长时间使用个人防护设备 (PPE)。这与有害影响有关，尤其是与皮肤健康有关。本研究描述了一项针对医护人员 (HCW) 的综合调查，以描述他们在管理 COVID-19 患者时使用 PPE 的经验，特别关注不良皮肤反应。一项 24 小时患病率研究和多中心前瞻性调查旨在捕捉 PPE 对医院工作人员皮肤健康的影响。调查问卷纳入了参与者的人口统计学信息、PPE 类型、使用时间和去除频率。参与者报告了任何相应的不良皮肤反应的性质和位置。患病率研究包括来自单一中心的所有重症监护病房的工作人员，而前瞻性研究则使用了英国三家急性护理提供者的便利样本工作人员。共有 108 名工作人员被纳入患病率研究，而来自各种专业背景和人口统计学的 307 名 HCW 参加了前瞻性研究。患病率研究报告了各种皮肤不良反应，鼻梁（69%）和耳朵（30%）是受影响最严重的部位。前瞻性研究记录了六种不良皮肤反应，最常见的是发红（33%）、瘙痒（22%）和压伤（12%）。这些主要发生在鼻梁和耳朵。PPE 使用的平均每日时间和 PPE 缓解频率与不良皮肤反应之间存在显著关联（P < .05）。这项全面的研究表明，PPE 的使用会导致 HCW 面部各个部位出现一系列皮肤反应。需要改进 PPE 使用指南以保护皮肤健康。此外，需要对 PPE 设计进行修改，以适应各种脸型，并使用合适的材料来提高设备安全性。
