Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review

Silva, Lorrany Fontenele Moraes da; Almeida, Alana Gomes de Araújo; Pascoal, Lí­via Maia; Neto, Marcelino Santos; Lima, Francisca Elisângela Teixeira; Santos, Floriacy Stabnow

doi:10.1590/1518-8345.5636.3522

Cited by 11 publications

(24 citation statements)

References 38 publications

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“…18 The results of one systematic review in 2022 also showed that masks caused pressure injuries are mainly grade 1. 20 In this regard, the results of Rafiei et al's study, which was conducted among nurses in Qazvin hospitals at the beginning of the COVID-19 pandemic, showed that in addition to grade 1 injuries, a significant percentage of PPE-related pressure injuries are grade 2, which it is different from the findings of the current study. 4 The differences between the two studies can be related to three reasons.…”

Section: Discussioncontrasting

confidence: 93%

“…Similar to this finding, the results of the study conducted in Turkey showed that the PPE‐related pressure injuries in healthcare providers are mostly grade 1 18 . The results of one systematic review in 2022 also showed that masks caused pressure injuries are mainly grade 1 20 . In this regard, the results of Rafiei et al's study, which was conducted among nurses in Qazvin hospitals at the beginning of the COVID‐19 pandemic, showed that in addition to grade 1 injuries, a significant percentage of PPE‐related pressure injuries are grade 2, which it is different from the findings of the current study 4 .…”

Section: Discussionsupporting

confidence: 69%

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ChitoHeal gel use on the nasal site for prevention of N95 masks caused pressure injuries: A randomised clinical trial

Fallahi

Rafiei

Rashvand

et al. 2023

International Wound Journal

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Prolonged use of personal protective equipment can cause pressure injuries on the skin. The current study was conducted with the aim of investigating the effect of ChitoHeal gel on the nasal site on the prevention of N 95 masks that caused pressure injuries in nurses working in intensive care units. This is a randomised controlled clinical trial that was conducted in 2022. The study sample consisted of 92 nurses working in the intensive care units. A randomised block method was used to allocate the nurses to two equal groups of intervention and control. However, in the intervention group, ChitoHeal gel was applied on nurses' nose bridge. To perform this, the researcher referred to the department during the morning and evening shifts and applied the gel on nurses' nose bridge at the beginning of each shift. Then, the N95 mask was installed on the face by the nurse. Before and at the end of each work shift, the skin in both groups was assessed for any signs of pressure injuries. No significant differences were observed between the two intervention and control groups in terms of demographic variables. The frequency distribution of mask‐caused pressure injuries on nurses' nose bridge in the two groups was analysed using the Chi‐square test (Fisher's exact test). The results showed that after the intervention, it was 0 in the intervention group. However, 4 nurses (8.6%) in the control group developed pressure injuries, and this difference between the two groups was statistically significant (P > .05). The result of the current study showed that the use of ChitoHeal gel is effective in preventing N95 mask‐related pressure injuries. Considering the cheapness and rational global availability of this gel, it seems that its use is an effective strategy in order to prevent N95 mask‐related pressure injuries. Given the lack of studies in this regard, similar studies are strongly recommended to be conducted.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionsupporting

confidence: 69%

ChitoHeal gel use on the nasal site for prevention of N95 masks caused pressure injuries: A randomised clinical trial

Fallahi

Rafiei

Rashvand

et al. 2023

International Wound Journal

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“…This is consistent with the results of previous studies (Gasparino et al, 2021). A recent comprehensive review (Silva et al, 2022) similarly showed that foam dressings were The prevention of MRDPI by foam dressings can be explained in two ways. First, foam dressings are highly resistant to pressure and shear forces (Graça et al, 2022).…”

Section: Discussionsupporting

confidence: 91%

“…This is consistent with the results of previous studies (Gasparino et al, 2021). A recent comprehensive review (Silva et al, 2022) similarly showed that foam dressings were effective for preventing skin damage caused by personal protective equipment during the COVID‐19 pandemic. The SUCRA values indicated that foam dressing was the best intervention.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of dressings preventing facial medical device‐related pressure injury in medical staff during the COVID‐19 pandemic: A systematic review and network meta‐analysis

Zhu

Su²,

Kong

et al. 2023

Journal of Clinical Nursing

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AimThis study systematically compared the efficacy of various dressings that may prevent facial medical device‐related pressure injury (MRDPI) in medical staff during the COVID‐19 pandemic.BackgroundDuring the COVID‐19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective.DesignA systematic review and network meta‐analysis, in accordance with PRISMA.MethodsA comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID‐19 pandemic and included an observation and control group.ResultsThe network meta‐analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative.ConclusionFoam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID‐19 pandemic, medical staff can use foam dressings to prevent MRDPI.Relevance to clinical practiceThe results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.

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“…One study found that among the complications caused by glove wearing, dryness (75%) and rash/itching (72.2%) were the main complaints ( 60 ), which was consistent with previous studies by Sliva et al ( 61 ) and Xia et al ( 62 ). In addition, sweating and redness could be also hand symptoms ( 63 ).…”

Section: Contact Dermatitis Caused By Ppe During the Covid-19 Pandemicsupporting

confidence: 87%

Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review

Tang

Wang

Hamblin

et al. 2023

Front. Public Health

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IntroductionDuring the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD).MethodsSubject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included.DiscussionThis article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.

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Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review

Cited by 11 publications

References 38 publications

ChitoHeal gel use on the nasal site for prevention of N95 masks caused pressure injuries: A randomised clinical trial

ChitoHeal gel use on the nasal site for prevention of N95 masks caused pressure injuries: A randomised clinical trial

Evaluation of dressings preventing facial medical device‐related pressure injury in medical staff during the COVID‐19 pandemic: A systematic review and network meta‐analysis

Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review

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