Prolonged PPE use causing skin injury
NEW DELHI: Prolonged personal protective equipment (PPE) use can lead to serious skin injuries, a study covering 161 hospitals treating Covid-19 patients in China has found, and said that preventive measures be institutionalised for doctors and nurses at the forefront of the battle against the contagion.
The study, to be published in the journal Advances in Wound Care, looked at 4,308 health care respondents from across 28 provinces in China and found that 42.8% had some form of skin injury related to PPE.
The most common forms were device-related pressure injuries, moisture-associated skin damage, and skin tears, and they were sometimes found at multiple parts of the body. The PPE was worn on average daily for 7.7 hours and roughly a third of respondents reported heavy sweating while wearing them.
Two kinds of PPE were considered: Grade 2, comprising surgical masks with goggles or protective face masks and protective gowns used for moderate risk of exposure to the virus; and Grade 3, N-95 respirators with goggles or protective face masks, protective gowns, latex gloves, and shoes used by staff with a high risk of exposure to the virus. Men formed 12% of the respondents while women 88%. Almost 12% (11.7%) were doctors and 88.3% were nurses.
In many cases, the kind of injuries on doctors and nurses were more severe than those in patients they were treating. “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 patients as well as in their health care providers,” said Chandan K Sen, a professor at Indiana University. The researchers offered several reasons for the injuries. The first, while staff using PPE should be replaced every four hours, many worked for 8-12 hours continuously.
In India, health care staff faces similar problems, said experts. “Duty hours should not be more than six hours,” said Girish Tyagi, member, the Delhi Medical Council.