Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.
Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.
J Eur Acad Dermatol Venereol. 2021 Oct;35(10):1994-2006. doi: 10.1111/jdv.17436. Epub 2021 Jun 29.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that has spread all over the word. To avoid the virus transmission, healthcare workers must wear adequate personal protective equipment (PPE). PPE is associated with several side events, including skin reactions. The objective of this study was to summarize the prevalence, type and risk factors for cutaneous adverse events related to PPE and prevention measures to avoid them. A systematic review and meta-analysis was conducted using MEDLINE, Scopus and EMBASE databases from conception to 21 January 2021. All types of epidemiological studies regarding skin adverse events related to PPE were included. The literature search identified 1007 references, 35 of them met the eligible criteria and were included for analysis, representing 31 453 participants. The media of skin side events related to PPE was 75.13%. The rate of cutaneous adverse events related to mask was 57.71%, and those associated with gloves and hand hygiene products was 49.16%. Most common skin adverse events were contact dermatitis, acne and itching. The most damaged anatomical regions were the nasal bridge, the cheeks and the hands. The duration of PPE wearing was the most common risk factor. Frequent handwashing, gloves and masks were the agents most frequently related to skin reactions. N95 respirators were the most harmful mask type for the skin. Hydrocolloid use prevented from developing skin adverse events related to masks. In conclusion, the rate of cutaneous adverse events related to PPE use is high. A longer duration of PPE wearing was the most common risk factor. Using hydrocolloid could prevent from skin injuries related to mask use.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是一种全球性大流行病毒，已蔓延至世界各地。为了避免病毒传播，医护人员必须穿戴适当的个人防护设备（PPE）。PPE 会引起多种副作用，包括皮肤反应。本研究旨在总结与 PPE 相关的皮肤不良事件的发生率、类型和危险因素，以及预防措施。我们使用 MEDLINE、Scopus 和 EMBASE 数据库进行了系统评价和荟萃分析，检索时间从建库至 2021 年 1 月 21 日。所有与 PPE 相关皮肤不良事件的流行病学研究均被纳入。文献检索共识别出 1007 条参考文献，其中 35 条符合纳入标准并进行了分析，共纳入 31453 名参与者。PPE 相关皮肤不良反应的发生率为 75.13%。与口罩相关的皮肤不良反应发生率为 57.71%，与手套和手部卫生产品相关的皮肤不良反应发生率为 49.16%。最常见的皮肤不良反应为接触性皮炎、痤疮和瘙痒。最常受影响的解剖区域是鼻梁、脸颊和手部。PPE 穿戴时间是最常见的危险因素。频繁洗手、戴手套和口罩是最常与皮肤反应相关的因素。N95 口罩对皮肤的危害最大。使用水胶体敷料可预防与口罩相关的皮肤不良事件。总之，与 PPE 使用相关的皮肤不良事件发生率较高。PPE 穿戴时间较长是最常见的危险因素。使用水胶体敷料可预防与口罩使用相关的皮肤损伤。
