Abstract
With the spread of Coronavirus Disease 2019 globally, more than 40,000 healthcare staff rushed to Wuhan, Hubei Province to fight against this threatening disease. All staff had to wear personal protective equipment (PPE) for several hours when caring for patients, which resulted in adverse skin reactions and injuries. In this study, we used an online questionnaire to collect the self-reported skin damages among the first-line medical staff in the epidemic. The questionnaire was designed by four front-line wound care nurses and then revised through Delphi consultants. Items mainly focused on the adverse skin reactions and preventive strategies. The survey was distributed through phone application from March 15th to March 20th and received 275 responses in total. The prevalence of skin reactions (212, 77.09%) was high in both head and hands. The common clinical symptoms of skin reactions were redness, device-like mark, and burning pain in face; and dryness, dermatitis, and itch/irritation in hands. Three risk factors included gender, level of protection, and daily wearing time of PPE were identified that caused skin reactions among medical staff. 150 of 275 (54.55%) participants took preventive strategies like prophylactic dressings, however, more than 75% users had little knowledge about dressings. We suggest the frontline staff strengthened the protection of skin integrity and reduced the prevalence of adverse skin reactions after professional education.
Highlights
Series of pneumonia cases with unknown causes outbroke since December 2019 in Wuhan, Hubei Province China, later named as Coronavirus Disease 2019 (COVID-19) [1, 2]
Considering some manifestations or locations of device-related pressure injury (DRPI) was similar to partial skin reactions to protective equipment (PPE), we supposed that without professional training, it was difficult for medical staff to correctly distinguish adverse skin reactions from DRPI, moist-related associated dermatitis (MASD), skin tears, or other skin injuries [14]
Skins reactions were common in frontline healthcare providers fighting against COVID-19
Summary
The study was a cross-sectional multicenter study to identify the common adverse skin reactions and related risk factors of the frontline staff fighting against COVID-19 caused by wearing PPE.Infection control protocolsDuring the outbreak, infection control protocols in China must in accordance with national guidelines for infection control protocols [8]. The study was a cross-sectional multicenter study to identify the common adverse skin reactions and related risk factors of the frontline staff fighting against COVID-19 caused by wearing PPE. PPE usually included protective suit, N-95 respirator, 2-layer work caps and shoe covers, googles, disposable gloves and long-sleeve surgical gown. Primary protection included work clothes, work caps, gowns, gloves, and surgical masks. Medical staff must wear at least the second level of protection when directly caring patients with COVID-19. Secondary protection required to wear N95 mask, protective suit, goggles or face shields besides primary protection. When facing droplets from respiratory tract like intubation, medical staff were required to wear the third level of protection that included full-scale respiratory protective equipment in addition to the secondary protection
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