Protecting facial skin to reduce skin damage during COVID-19 pandemic

Abstract

Purpose: Medical device-related pressure injury (MDRPI) on the face caused by prolonged wearing of airtight sealed face masks is a serious concern of the healthcare workers in clinical settings during COVID-19 pandemic. The worries on the possible face injuries sustainable will bring unwell psychological effect on the healthcare workers and hence might affect the quality of care they are offering to the patients. In this regard, the prevention or mitigation measures to avoid or reduce the possible MDRPI becomes an imminent issue among healthcare workers in improving their personal protective equipment. This study aims to investigate the appropriateness and effectiveness of using prophylactic dressings in the prolonged wearing of respiratory protective equipment for preventing and improving the MDRPI on the face of healthcare worker.

Methods: This study made use of a mixed method and a randomized approach to divide thirty-four healthcare workers into two groups. One group applied prophylactic dressings when wearing the airtight sealed face masks over a few hours. The other group had not applied the dressings and was taken as the control group. The feedback of the user was collected afterward the user has finished the experiment.

Results: Twenty-four healthcare workers undertook and passed the respiratory protective equipment fit test with the dressings applied. The dressings effectively reduced hyperemia (100% vs 54%, p < 0.001, odds ratio (OR) = 0.07 (95% confidence interval (CI) = 0.16 – 0.31)) and medical device-related pressure injury (62% vs 0%, p < 0.001, OR = 0.38 (95% CI = 0.22–0.63)). The dressing, however, caused significant itching (0% vs 25%, p = 0.08, OR = 1.33 (95% CI = 1.05–1.68)). The discomfort level of the participants was 1.2-1.33 out of 10. As a result, most participants found the dressings tolerable. According to the healthcare workers’ feedback, they emphasized that they felt comfortable in wearing the face masks with the dressing, and there was reduction in skin redness caused by the tight fit of the face masks. They also acknowledged that air tightness of the face masks was still maintained despite the application of the dressing.

Conclusion: The result of this study illustrated that the use of dressings in the wearing of the airtight face masks can significantly mitigate MDRPI and hyperemia. The dressing was safe and effective in maintaining the airtightness when wearing the respiratory protective equipment. The qualitative results showed healthcare workers preferred to apply the dressing in wearing the airtight face masks. These findings offer an evidence-based strategy to deliver pre-emptive care practices for healthcare workers wearing respiratory protective equipment for prolonged periods.