Study Finds Nearly Half of Medical Staff Treating COVID-19 Experience Serious Skin Injuries from PPE

A new study has found that 42.8% of medical staff treating patients with the coronavirus disease 2019 (COVID-19) experienced serious skin injuries from the use of personal protective equipment (PPE), including masks, goggles, face shields, and protective gowns. The findings were published in Advances in Wound Care.

Although this was the first cross-sectional survey to understand PPE-caused skin injuries in medical staff, the authors noted that an earlier study in Wuhan, China, found that 80% of medical staff reported that various skin injuries damaged their health and increased the risk of infection.

Investigators performed a cross-sectional survey online between February 8 and 22, with questions that included demographic data, grade of PPE equipment, daily wearing time, skin injury types, and preventive measures.

A total of 4308 medical professionals responded from 161 hospitals. Of the 42.8% who reported skin injuries, the 3 types of injuries included device-related pressure injuries (DRPI), moist-associated skin damage (MASD), and skin tears (ST). Co-skin injuries and multiple location injuries accounted for 27.4% and 76.8%, respectively.

In total, 1844 survey respondents had 4735 skin injuries with an average of 2.6 skin injuries per person. The prevalence of DRPI, MASD, and ST were 30%, 10.8%, and 2%, respectively.

Furthermore, the authors found that 304 respondents reported coexistence between DRPI and MASD, 51 respondents reported coexistence of DRPI, MASD, and ST, 27 respondents reported coexistence between DRPI and ST, and 4 respondents had coexistence between MASD and ST.

Of the 1293 respondents with DRPI, 81.1% were stage 1, 18.3% were stage 2, and 0.6% had deep tissue injury. All 86 respondents with ST had type 1.

After performing a logistic regression analysis, the investigators concluded that sweating, daily wearing time, being male, and grade 3 PPE were associated with skin injuries. Notably, only 17.7% of respondents took prevention and 45% of skin injuries were treated.

“These significant findings are consistent with independent observations in Europe and United States, and call for systematic studies addressing skin injury and repair in COVID-19 positive patients as well as in their health care providers,” said Advances in Wound Care Editor-in-Chief Chandan K. Sen, PhD, in a statement.

REFERENCE

Jiang Q, Song S, Zhou J, et al. The Prevalence, Characteristics, and Prevention Status of Skin Injury Caused by Personal Protective Equipment Among Medical Staff in Fighting COVID-19: A Multicenter, Cross-Sectional Study. Advances in Wound Care; April 27, 2020. https://www.liebertpub.com/doi/10.1089/wound.2020.1212. Accessed May 8, 2020.