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. 2020 Jul;9(7):357-364.
doi: 10.1089/wound.2020.1212. Epub 2020 Apr 27.

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

Qixia Jiang  1 , Siping Song  2 , Jihong Zhou  1 , Yuxiu Liu  3 , Aihua Chen  4 , Yuxuan Bai  5 , Jing Wang  6 , Zhixia Jiang  7 , Yanhong Zhang  8 , Haiying Liu  9 , Jiao Hua  10 , Jinli Guo  11 , Qiuying Han  12 , Yongli Tang  13 , Jiayu Xue  14
Affiliations

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

Qixia Jiang et al. Adv Wound Care (New Rochelle). 2020 Jul.

Abstract

Objective: To investigate the prevalence, characteristics, and preventive status of skin injuries caused by personal protective equipment (PPE) in medical staff. Approach: A cross-sectional survey was conducted online for understanding skin injuries among medical staff fighting COVID-19 in February 8-22, 2020. Participants voluntarily answered and submitted the questionnaire with cell phone. The questionnaire items included demographic data, grade of PPE and daily wearing time, skin injury types, anatomical sites, and preventive measures. Univariable analyses and logistic regression analyses were used to explore the risk factors associated with skin injuries. Results: A total of 4,308 respondents were collected from 161 hospitals and 4,306 respondents were valid. The overall prevalence of skin injuries was 42.8% (95% confidence interval [CI] 41.30-44.30) with three types of device-related pressure injuries, moist-associated skin damage, and skin tear. Co-skin injuries and multiple location injuries were 27.4% and 76.8%, respectively. The logistic regression analysis indicated that sweating (95% CI for odds ratio [OR] 87.52-163.11), daily wearing time (95% CI for OR 1.61-3.21), male (95% CI for OR 1.11-2.13), and grade 3 PPE (95% CI for OR 1.08-2.01) were associated with skin injuries. Only 17.7% of respondents took prevention and 45.0% of skin injuries were treated. Innovation: This is the first cross-sectional survey to understand skin injuries in medical staff caused by PPE, which is expected to be a benchmark. Conclusion: The skin injuries among medical staff are serious, with insufficient prevention and treatment. A comprehensive program should be taken in the future.

Keywords: COVID-19; cross-sectional survey; medical staff; occupational injury; personal protective equipment; skin injury.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in this work. No ghost writer was used for the preparation of this article.

Figures

None
Qixia Jiang, MSN, RN, ET
Figure 1.
Figure 1.
The classification of ST by the International Skin Tear Advisory Panel. ST, skin tears.
Figure 2.
Figure 2.
(A) DRPI+MASD on forehead. (B) MASD+ST on hands. (C) DRPI+ST+MASD on face. (D) ST on forehead. (E) MASD on palm. (F) MASD+DRPI on neck. DRPI, device-related pressure injury; MASD, moisture-associated skin damage.
See this image and copyright information in PMC

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