Consensus of Chinese experts on protection of skin and mucous membrane barrier for health‐care workers fighting against coronavirus disease 2019

Yan, Yicen; Chen, Hui; Chen, Liuqing; Cheng, Bo; Diao, Peng; Dong, Liyun; Gao, Xinghua; Gu, Heng; He, Li; Ji, Chao; Jin, Hongzhong; Wei, Lai; Lei, Tiechi; Li, Li; Li, Liuyi; Li, Ruoyu; Liu, Dongxian; Liu, Wei; Lu, Qianjin; Shi, Ying; Song, Jiquan; Tao, Juan; Wang, Baoxi; Wang, Gang; Wu, Yan; Xiang, Leihong; Xie, Jun; Xu, Jinhua; Yao, Zhirong; Zhang, Furen; Zhang, Jianzhong; Zhong, Shaomin; Li, Hengjin; Li, Hang

doi:10.1111/dth.13310

Cited by 262 publications

(451 citation statements)

References 12 publications

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“…Different methods can be chosen for the disinfection of hands and surfaces. Ultraviolet (UV) disinfection, hot water bath with temperature of [ 56°C (132.8°K) for 30 min, chlorine-containing disinfectants, peracetic acid or 75% ethanol can effectively inactivate the virus [136][137][138].…”

Section: Recommendations On Decontamination and Cleaningmentioning

confidence: 99%

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

101

145

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Background The worldwide spread of a novel coronavirus disease has led to a near total stop of nonurgent, elective surgeries across all specialties in most affected countries. In the field of aesthetic surgery, the selfimposed moratorium for all aesthetic surgery procedures recommended by most international scientific societies has been adopted by many surgeons worldwide and resulted in a huge socioeconomic impact for most private practices and clinics. An important question still unanswered in most countries is when and how should elective/aesthetic procedures be scheduled again and what kind of organizational changes are necessary to protect patients and healthcare workers when clinics and practices reopen. Defining manageable, evidence-based protocols for testing, surgical/ procedural risk mitigation and clinical flow management/contamination management will be paramount for the safety of non-urgent surgical procedures. Methods We conducted a MEDLINE/PubMed research for all available publications on COVID-19 and surgery and COVID-19 and anesthesia. Articles and referenced literature describing possible procedural impact factors leading to exacerbation of the clinical evolution of COVID-19positive patients were identified to perform risk stratification for elective surgery. Based on these impact factors, considerations for patient selection, choice of procedural complexity, duration of procedure, type of anesthesia, etc., are discussed in this article and translated into algorithms for surgical/anesthesia risk management and clinical management. Current recommendations and published protocols on contamination control, avoidance of crosscontamination and procedural patient flow are reviewed. A COVID-19 testing guideline protocol for patients planning to undergo elective aesthetic surgery is presented and recommendations are made regarding adaptation of current patient information/informed consent forms and patient health questionnaires. Conclusion The COVID-19 crisis has led to unprecedented challenges in the acute management of the crisis, and the wave only recently seems to flatten out in some countries. The adaptation of surgical and procedural steps for a riskminimizing management of potential COVID-19-positive patients seeking to undergo elective aesthetic procedures in the wake of that wave will present the next big challenge for the aesthetic surgery community. We propose a clinical algorithm to enhance patient safety in elective surgery in the context of COVID-19 and to minimize cross-contamination between healthcare workers and patients. New evidence-based guidelines regarding surgical risk stratification, testing, and clinical flow management/contamination management are proposed. We believe that only the continuous development and broad implementation of guidelines like the ones proposed in this paper will allow an early reintegration of all aesthetic procedures into the scope of surgical care currently performed and to prepare

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Section: Recommendations On Decontamination and Cleaningmentioning

confidence: 99%

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

101

145

View full text Add to dashboard Cite

show abstract

“…Heat and dehydration were major complications of both goggles and face shields application during the Ebola outbreak [7]. Other dermatologic side-effects such as pressure injury, contact dermatitis, urticaria, xerosis and aggravation of underlying dermatosis might occur due to the impairment of the skin integrity during mechanical trauma of goggles [8]. A study by Lan et al, [2] revealed that 87.9% of HCWs, who were wearing goggles for more than 6 hours, developed skin reactions on their nasal bridge.…”

Section: To Editormentioning

confidence: 99%

Skin reactions to non‐glove personal protective equipment: an emerging issue in the COVID‐19 pandemic

Gheisari

Araghi

Moravvej

et al. 2020

Acad Dermatol Venereol

102

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“…3 To this end, several measures to avoid hand dermatitis, maceration, and erosion due to PPE and handwashing during the pandemic have been proposed. 4 Although the application of hand cream/moisturizers on intact skin after hand washing is recommended, 6 only 22.1% applied hand creams after washing. 3,4 Education of HCWs regarding proper skin care management may be effective in preventing occupational skin disorders.…”

Section: The Role Of Occupational Dermatology In the Covid-19 Outbreakmentioning

confidence: 99%

The role of occupational dermatology in the COVID‐19 outbreak

et al. 2020

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It is known that in emergency medicine and disaster management, skin diseases may be frequent not only in victims, but also in rescuers. 2 The current COVID-19 pandemic demonstrates that health-care workers (HCWs) are particularly affected by skin problems. Although not a severe disease, skin problems often have a significant impact on emergency management, as they are potentially able to reduce the effective workforce.HCWs caring for COVID-19 patients have to wear for many hours, on a daily basis, specific personal protective equipment (PPE) and are therefore susceptible to PPE-related adverse skin reactions. 3It has been reported that up to 97% of HCWs showed skin lesions related to the enhanced protection measures, mainly affecting the nasal bridge, cheek, forehead, and hands. 1,3,4 The facial lesions are secondary not only to the prolonged use of N95 FFP3 masks, but mainly to goggles, which were implicated in most injuries. Hand hygiene with alcohol-based hand rubs is widely used as one of the most effective, simple, and low-cost procedures against COVID-19 cross-transmission. 5 By denaturing proteins, alcohol inactivates enveloped viruses, including coronaviruses, and thus alcohol-based formulations with at least 60% ethanol have been proven effective for hand hygiene. 5 Moreover, HCWs may perform frequent handwashing with water and soap more than 10 times per day. Because coronavirus was found to survive for several hours on used PPE, double gloving can reduce the risks of viral contamination during PPE removal and is therefore recommended. 3 These procedures may lead to hand dermatitis with symptoms that can vary from quite mild to debilitating, including dryness, irritation, itching, and even fissuring and bleeding. 1,3,4 The problem of hand dermatitis is very important for many aspects. First, hand dermatitis due to frequent washing may create a route of entry for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); indeed, angiotensin-converting enzyme 2, the receptor for the virus, is richly expressed in the skin on blood vessels, basal cells, hair follicles, eccrine glands. 4 Second, dryness, skin irritation, and itching can be debilitating and cause absence from work and impair work productivity, with important consequences during the pandemic. Therefore, basic skin care measures should be taken after hand washing to address these aspects. 3 To this end, several measures to avoid hand dermatitis, maceration, and erosion due to PPE and handwashing during the pandemic have been proposed. 4 Although the application of hand cream/moisturizers on intact skin after hand washing is recommended, 6 only 22.1% applied hand creams after washing. 3,4 Education of HCWs regarding proper skin care management may be effective in preventing occupational skin disorders. For HCWs at risk of hand dermatitis to hygiene products, additional skin moisturizing may be needed. Hand lotions and creams often contain humectants, fats, and oils that increase skin hydration and replace altered or depleted skin lipid...

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Consensus of Chinese experts on protection of skin and mucous membrane barrier for health‐care workers fighting against coronavirus disease 2019

Cited by 262 publications

References 12 publications

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Skin reactions to non‐glove personal protective equipment: an emerging issue in the COVID‐19 pandemic

The role of occupational dermatology in the COVID‐19 outbreak

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