Skin problems associated with using of personal protective equipment in COVID-19 intensive care units

Health care workers, who worked intensively during the COVID-19 pandemic, faced some problems, including skin problems, due to the personal protective equipment (PPE) they used to control the spread of infection.

This study aimed to identify the skin problems because of using PPE by nurses during the delivery of health care in three COVID-19 intensive care units (ICUs) within one hospital service.

The study was designed as a cross-sectional survey. The study was conducted with nurses working in three intensive care units in the metropolitan districts of Ankara, Turkey. The data were collected online with a questionnaire developed by the researchers between December 2021 and June 2022.

In this study, 82/120 (68.33%) nurses responded to the questionnaire at least once during the distribution period. The mean of the duration of PPE utilization per each time including goggles, N95 mask, bonnet, face-shield, gloves, boots/shoe covers and coverall was 3.76 ± 1.36 h. The proportion of nurses who experienced any skin problem related to any PPE at least two or more was 74/82 (90.24%). The proportion of pressure sores, acne, skin reaction including allergic dermatitis or contact urticaria, and regional pain varied between 4.9% and 79.3%. The proportion of nurses who applied any protective application to prevent skin problems was 53.66%. Among the protective applications, pressure-reducing surfaces were used the most. The use of protective applications for goggles (p = .010), bonnet (p = .000) and face shield (p = .000) effectively reduced PPE-related skin problems.

During the pandemic, nurses faced a wide variety of skin problems because of PPEs. It may be beneficial to design a study programme that reduces the duration of PPEs use in clinics. In addition, there is a need for effective protective applications to prevent skin problems and new development of PPE that do not cause skin problems.

In the pandemic, skin problems have developed because of the use of PPE in nurses who provide health care, intensively. These problems, which were not seen as a priority in the pandemic, may adversely affect the health of nurses, their performance in the treatment and care process and their work quality.