Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review

Silva, Lorrany Fontenele Moraes da; Almeida, Alana Gomes de Araujo; Pascoal, Lívia Maia; Santos Neto, Marcelino; Lima, Francisca Elisângela Teixeira; Santos, Floriacy Stabnow

doi:10.1590/1518-8345.5636.3522

Lorrany Fontenele Moraes da Silva

Universidade Federal do Maranhão, Centro de Ciências Sociais, Saúde e Tecnologia, Imperatriz, MA, Brazil.

Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

http://orcid.org/0000-0002-3683-4969

Alana Gomes de Araujo Almeida

Universidade Federal do Maranhão, Centro de Ciências Humanas, Naturais, Saúde e Tecnologia, Pinheiro, MA, Brazil.

http://orcid.org/0000-0002-4411-0354

Lívia Maia Pascoal ^**Corresponding author: Lívia Maia Pascoal E-mail: livia_mp@hotmail.com

Universidade Federal do Maranhão, Centro de Ciências Sociais, Saúde e Tecnologia, Imperatriz, MA, Brazil.

http://orcid.org/0000-0003-0876-3996

Marcelino Santos Neto

Universidade Federal do Maranhão, Centro de Ciências Sociais, Saúde e Tecnologia, Imperatriz, MA, Brazil.

http://orcid.org/0000-0002-6105-1886

Francisca Elisângela Teixeira Lima

Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brazil.

Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.

http://orcid.org/0000-0002-7543-6947

Floriacy Stabnow Santos

Universidade Federal do Maranhão, Centro de Ciências Sociais, Saúde e Tecnologia, Imperatriz, MA, Brazil.

http://orcid.org/0000-0001-7840-7642

*Corresponding author: Lívia Maia Pascoal E-mail: livia_mp@hotmail.com

Associate Editor

Maria Lúcia Zanetti.

Authors’ contribution

Study concept and design: Lorrany Fontenele Moraes Da Silva, Lívia Maia Pascoal, Marcelino Santos Neto, Francisca Elisângela Teixeira Lima, Floriacy Stabnow Santos. Obtaining data: Lorrany Fontenele Moraes Da Silva, Alana Gomes de Araujo Almeida. Data analysis and interpretation: Lorrany Fontenele Moraes Da Silva, Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Marcelino Santos Neto, Francisca Elisângela Teixeira Lima, Floriacy Stabnow Santos. Statistical analysis: Alana Gomes de Araujo Almeida, Lívia Maia Pascoal. Obtaining financing: Lívia Maia Pascoal. Drafting the manuscript: Lorrany Fontenele Moraes Da Silva, Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Marcelino Santos Neto, Francisca Elisângela Teixeira Lima, Floriacy Stabnow Santos. Critical review of the manuscript as to its relevant intellectual content: Lorrany Fontenele Moraes Da Silva, Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Marcelino Santos Neto, Francisca Elisângela Teixeira Lima, Floriacy Stabnow Santos. All authors approved the final version of the text.

Conflict of interest

The authors have declared that there is no conflict of interest.

Database	Crossing	Number
MEDLINE	COVID-19 AND (“protective devices” OR “personal protective equipment”) AND (skin OR “device related pressure injuries” OR “facial injuries” OR “occupational injury” OR “skin injury” OR “skin damage”).	99
CINAHL	(MH”protective devices”) OR (MH”personal protective equipment”) AND (skin OR “device related pressure injuries” OR (MH”facial injuries”) OR (MH “occupational injury”) OR “skin injury” OR “skin damage”)	45
LILACS	COVID-19 AND (“dispositivos de protección” OR “equipo de protección personal”) AND (piel OR “lesiones por presión relacionadas con el dispositivo” OR “lesiones faciales” OR “lesión ocupacional” OR “lesión cutánea” OR “daño cutáneo”)	1
SCOPUS	COVID-19 AND (“protective devices” OR “personal protective equipment”) AND (skin OR “device related pressure injuries” OR “facial injuries” OR “occupational injury” OR “skin injury” OR “skin damage”).	97
Science Direct	COVID-19 AND (“protective devices” OR “personal protective equipment”) AND (skin OR “device related pressure injuries” OR “facial injuries” OR “occupational injury” OR “skin injury” OR “skin damage”).	566
Web of Science	COVID-19 AND (“protective devices” OR “personal protective equipment”) AND (skin OR “device related pressure injuries” OR “facial injuries” OR “occupational injury” OR “skin injury” OR “skin damage”).	42
SciELO	COVID-19 AND (“dispositivos de protección” OR “equipo de protección personal”) AND (piel OR “lesiones por presión relacionadas con el dispositivo” OR “lesiones faciales” OR “lesión ocupacional” OR “lesión cutánea” OR “daño cutáneo”)	1
TOTAL		851

Authors	Objective	Language/Country	Level of Evidence	Methodological quality of the study
Smart, et al. (2020)¹⁷17. Smart H, Opinion FB, Darwich I, Elnawasany MA, Kodange C. Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements. Adv Skin Wound Care. 2020;33(8):418-27. doi: https://doi.org/10.1097/01.ASW.0000669920.94084.c1 https://doi.org/10.1097/01.ASW.000066992...	To determine whether a silicone-based dressing worn under an N95 mask is safe and beneficial for preventing facial skin injury without compromising the mask’s seal.	English/Bahrain	3.c	Seven out of 11 points in the JBI* checklist for Cohort studies
Yildiz, et al. (2021)¹⁸18. Yildiz A, Karadag A, Yildiz A, Çakar V. Determination of the effect of prophylactic dressing on the prevention of skin injuries associated with personal protective equipments in health care workers during COVID-19 pandemic. J Tissue Viability. 2021;30(1):21-7. doi: https://doi.org/10.1016/j.jtv.2020.10.005 https://doi.org/10.1016/j.jtv.2020.10.00...	To determine the effect of the prophylactic dressing on preventing skin lesions due to PPE use in health professionals working with COVID-19 patients.	English/Turkey	3.c	Eight out of 11 points in the JBI* checklist for Cohort studies
Hua, et al. (2020)¹⁹19. Hua W, Zuo Y, Wan R, Xiong L, Tang J, Zou L, et al. Short-term skin reactions following use of N95 respirators and medical masks. Contact Dermatitis. 2020;83(2):115-21. doi: https://doi.org/10.1111/cod.13601 https://doi.org/10.1111/cod.13601...	To analyze the short-term effects of N95 respirators and medical masks on the physiological properties of the skin and to report adverse skin reactions.	English/China	1.c	Eight out of 13 points in the JBI* checklist for Randomized controlled trials
Gasparino, et al. (2021)²⁰20. Gasparino RC, Lima MHM, Souza Oliveira-Kumakura AR, Silva VA, Jesus Meszaros M, Antunes IR. Prophylactic dressings in the prevention of pressure ulcer related to the use of personal protective equipment by health professionals facing the COVID-19 pandemic: A randomized clinical trial. Wound Repair Regen. 2021;29(1):183-8. doi: https://doi.org/10.1111/wrr.12877 https://doi.org/10.1111/wrr.12877...	To compare the use of foam and extra-thin hydrocolloid dressing in the prevention of pressure ulcers associated with the use of PPE by health professionals working on the front line against the Coronavirus.	English/Brazil	1.c	Eight out of 13 points in the JBI* checklist for Randomized controlled trials
Jiang, et al. (2020)²¹21. Jiang Q, Liu Y, Wei W, Zhu D, Chen A, Liu H, et al. The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID-19 in China: A multicentre cross-sectional survey. Int Wound J. 2020;17:1300-9. doi: https://doi.org/10.1111/iwj.13391 https://doi.org/10.1111/iwj.13391...	To investigate the prevalence and characteristics of pressure ulcers among health team members.	English/China	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Hu, et al. (2020)²²22. Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020 Jun 12;99(24):e20603. doi: https://doi.org/10.1097/MD.0000000000020603 https://doi.org/10.1097/MD.0000000000020...	To explore adverse skin reactions among health professionals who use PPE.	English/China	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Shanshal, et al. (2020)²³23. Shanshal M, Ahmed HS, Asfoor H, Salih RI, Ali SA, Aldabouni YK. Impact of COVID-19 on medical practice: A nationwide survey of dermatologists and health care providers in Iraq. Clin Dermatol. 2020. doi: https://doi.org/10.1016/j.clindermatol.2020.11.010 https://doi.org/10.1016/j.clindermatol.2...	To comprehensively examine the effect of COVID-19 on different aspects of the medical practice.	English/Iraq	4.b	Four out of eight points in the JBI* checklist for Analytical cross-sectional studies
Xia, et al. (2020)²⁴24. Xia W, Fu L, Liao H, Yang C, Guo H, Bian Z. The physical and psychological effects of personal protective equipment on health care workers in Wuhan, China: A Cross-Sectional Survey Study. J Emergency Nurs. 2020;46(6):791-801. doi: https://doi.org/10.1016/j.jen.2020.08.004 https://doi.org/10.1016/j.jen.2020.08.00...	To identify physical and psychological effects of using PPE and its related safety measures on health care workers in Wuhan, China, in response to the pandemic.	English/China	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Pacis, et al. (2020)²⁵25. Pacis M, Azor-Ocampo A, Burnett E, Tanasapphaisal C, Coleman B. Prophylactic Dressings for Maintaining Skin Integrity of Healthcare Workers When Using N95 Respirators While Preventing Contamination Due to the Novel Coronavirus: A Quality Improvement Project. J Wound Ostomy Continence Nurs. 2020;47(6):551-7. doi: https://doi.org/10.1097/WON.0000000000000713 https://doi.org/10.1097/WON.000000000000...	To formulate procedures to protect the integrity of health care workers’ facial skin when caring for COVID-19 patients.	English/United States	4.b	Five out of eight points in the JBI* checklist for Analytical cross-sectional studies
Agarwal, et al. (2020)²⁶26. Agarwal A, Agarwal S, Motiani P. Difficulties Encountered While Using PPE Kits and How to Overcome Them: An Indian Perspective. Cureus. 2020;12(11):e11652. doi: https://doi.org/10.7759/cureus.11652 https://doi.org/10.7759/cureus.11652...	To identify the difficulties encountered by health professionals during PPE use and to propose ways and means to help them overcome such difficulties.	English/India	4.b	Four out of eight points in the JBI* checklist for Analytical cross-sectional studies
Yuan, et al. (2020)²⁷27. Yuan N, Yang WX, Lu JL, Lv ZH. Investigation of adverse reactions in healthcare personnel working in Level 3 barrier protection PPE to treat COVID-19. Postgrad Med J. 2020;(1148):351-4. doi: https://doi.org/10.1136/postgradmedj-2020-137854 https://doi.org/10.1136/postgradmedj-202...	To understand the possible skin, respiratory, nervous and digestive reactions in Chinese health professionals who use PPE in the fight against COVID-19.	English/China	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Jiang, et al. (2020)²⁸28. Jiang Q, Song S, Zhou J, Liu Y, Chen A, et al. 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 Advances in Wound Care. 2020;9(7):357-64. doi: https://doi.org/10.1089/wound.2020.1212 https://doi.org/10.1089/wound.2020.1212...	To investigate the prevalence, characteristics and preventive status of skin lesions caused by PPE in the health team.	English/China	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Daye, et al. (2020)²⁹29. Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther. 2020;33(6):e14346. doi: https://doi.org/10.1111/dth.14346 https://doi.org/10.1111/dth.14346...	To evaluate the skin problems and dermatological quality of life of health professionals due to PPE use.	English/Turkey	4.b	Four out of eight points in the JBI* checklist for Analytical cross-sectional studies
Atay, et al. (2020)³⁰30. Atay S, Cura SÜ. Problems Encountered by Nurses Due to the Use of Personal Protective Equipment During the Coronavirus Pandemic: Results of a Survey. Wound Manag Prev. 2020;66(10):12-6. doi: https://doi.org/10.25270/wmp.2020.10.1216 https://doi.org/10.25270/wmp.2020.10.121...	To examine the physical issues related to PPE and prolonged wear time experienced by nurses during the COVID-19 pandemic.	English/Turkey	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Techasatian, et al. (2020)³¹31. Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, et al. The effects of the face mask on the skin underneath: A prospective survey during the COVID-19 Pandemic. J Prim Care Community Health. 2020;11:2150132720966167. doi: https://doi.org/10.1177/2150132720966167 https://doi.org/10.1177/2150132720966167...	To analyze the prevalence and possible risk factors to prevent face mask-related skin reactions during COVID-19.	English/Thailand	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Masen, et al. (2020)³²32. Masen MA, Chung A, Dawczyk JU, Dunning Z, Edwards L, Guyott C, et al. Evaluating lubricant performance to reduce COVID-19 PPE-related skin injury. PLoS One. 2020;15(9):e0239363. doi: https://doi.org/10.1371/journal.pone.0239363 https://doi.org/10.1371/journal.pone.023...	To provide a practical lubricating solution for COVID-19 front line health care workers working a four-hour shift or longer wearing PPE.	English/Paris (France)	4.b	Six out of eight points in the JBI* checklist for Analytical cross-sectional studies
Erize-Herrera, et al. (2020)³³33. Erize-Herrera JA, García-Mireles V, Uh-Sánchez I, Felix-Téllez F, Encarnación-Martínez M, Estrada-Aguilar L. Dermatological manifestations in healthcare workers associated with the use of personal protective equipment when attending patients with COVID-19 infection in hospitals in the metropolitan area of Mexico city. Piel. 2020. doi: https://doi.org/10.1016/j.piel.2020.10.004 https://doi.org/10.1016/j.piel.2020.10.0...	To describe the frequency of cutaneous manifestations caused by PPE use in health professionals and the risk factors for developing them.	Spanish/Mexico	4.b	Four out of eight points in the JBI* checklist for Analytical cross-sectional studies

Personal Protective Equipment	Types of injuries	Frequency n (%)*	Studies found
Surgical or N95 mask	Pressure ulcer (stage 1)^†	6 (35.2)	17,18,21,23,24,28
	Acne	4 (23.5)	22,29,31,33
	Skin depression	4 (23.5)	17,19,22,27
	Irritant contact dermatitis	3 (17.6)	22,29,33
	Cutaneous rash	3 (17.6)	23,26,31
	Pressure ulcer (stage 2)^†	2 (11.7)	21,23
	Injuries associated with moisture	2 (11.7)	18,24
	Maceration	1 (5.8)	33
	Cheilitis	1 (5.8)	30
	Pressure ulcer (stage 3)^†	1 (5.8)	21
	Urticaria	1 (5.8)	22
	Pustule	1 (5.8)	23
	Papule	1 (5.8)	23
	Xerosis	1 (5.8)	33
	Bubbles	1 (5.8)	33
Safety goggles	Pressure ulcer (stage 1)^‡	4 (23.5)	18,23,24,28
	Pressure ulcer (stage 2)^‡	3 (17.6)	21,23,28
	Cutaneous rash	2 (11.7)	23,33
	Skin depression	1 (5.8)	27
	Pressure ulcer (stage 3)^‡	1 (5.8)	21
	Papule	1 (5.8)	23
	Pustule	1 (5.8)	23
Face shield	Pressure ulcer (stage 1)^§	4 (23.5)	21,23,24,28
	Pressure ulcer (stage 2)^§	2 (11.7)	23,28
	Cutaneous rash	2 (11.7)	20,23
	Skin depression	1 (5.8)	27
	Injuries associated with moisture	1 (5.8)	18
	Folliculitis	1 (5.8)	18
	Friction injury	1 (5.8)	18
	Pressure ulcer (stage 3)^§	1 (5.8)	21
	Papule	1 (5.8)	23
	Pustule	1 (5.8)	23
Gloves	Xerosis	4 (23.5)	22,30,31,33
	Fissures	3 (17.6)	22,29,30
	Flaking	2 (11.7)	29,33
	Cutaneous rash	2 (11.7)	22,26
	Irritant contact dermatitis	1 (5.8)	26
	Maceration	1 (5.8)	33
	Bubbles	1 (5.8)	33
	Worsening of preexisting dermatosis	1 (5.8)	29
	Friction injury	1 (5.8)	18
	Injuries associated with moisture	1 (5.8)	18
	Urticaria	1 (5.8)	22
	Lichenification	1 (5.8)	29
Protective clothing	Irritant contact dermatitis	2 (11.7)	23,26
	Cutaneous rashes	1 (5.8)	26
	Injuries associated with moisture	1 (5.8)	18
	Xerosis	1 (5.8)	22

Recommendations for the prevention of injuries related to the use of masks, glasses and face shields
- Use an alcohol-free liquid protective barrier in areas of direct contact with PPE (e.g.: nose, cheeks, forehead, behind the ears) to protect the skin from moisture and friction. Before applying, make sure that the area is free of makeup. Do not apply to eyes or eyelids and allow to dry for 90 seconds before putting on the PPE²⁵25. Pacis M, Azor-Ocampo A, Burnett E, Tanasapphaisal C, Coleman B. Prophylactic Dressings for Maintaining Skin Integrity of Healthcare Workers When Using N95 Respirators While Preventing Contamination Due to the Novel Coronavirus: A Quality Improvement Project. J Wound Ostomy Continence Nurs. 2020;47(6):551-7. doi: https://doi.org/10.1097/WON.0000000000000713 https://doi.org/10.1097/WON.000000000000... .
- Apply a thin hydrocolloid or foam dressing and adjust the material to the skin without tensioning it on the bridge of the nose, cheeks and forehead, covering the area where the mask, face shield and goggles rest¹⁷17. Smart H, Opinion FB, Darwich I, Elnawasany MA, Kodange C. Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements. Adv Skin Wound Care. 2020;33(8):418-27. doi: https://doi.org/10.1097/01.ASW.0000669920.94084.c1 https://doi.org/10.1097/01.ASW.000066992... ^-¹⁸18. Yildiz A, Karadag A, Yildiz A, Çakar V. Determination of the effect of prophylactic dressing on the prevention of skin injuries associated with personal protective equipments in health care workers during COVID-19 pandemic. J Tissue Viability. 2021;30(1):21-7. doi: https://doi.org/10.1016/j.jtv.2020.10.005 https://doi.org/10.1016/j.jtv.2020.10.00... ^,²⁰20. Gasparino RC, Lima MHM, Souza Oliveira-Kumakura AR, Silva VA, Jesus Meszaros M, Antunes IR. Prophylactic dressings in the prevention of pressure ulcer related to the use of personal protective equipment by health professionals facing the COVID-19 pandemic: A randomized clinical trial. Wound Repair Regen. 2021;29(1):183-8. doi: https://doi.org/10.1111/wrr.12877 https://doi.org/10.1111/wrr.12877... ^,²³23. Shanshal M, Ahmed HS, Asfoor H, Salih RI, Ali SA, Aldabouni YK. Impact of COVID-19 on medical practice: A nationwide survey of dermatologists and health care providers in Iraq. Clin Dermatol. 2020. doi: https://doi.org/10.1016/j.clindermatol.2020.11.010 https://doi.org/10.1016/j.clindermatol.2... ^,²⁸28. Jiang Q, Song S, Zhou J, Liu Y, Chen A, et al. 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 Advances in Wound Care. 2020;9(7):357-64. doi: https://doi.org/10.1089/wound.2020.1212 https://doi.org/10.1089/wound.2020.1212... .
- Use acrylate-based moisturizers frequently, especially when not in direct patient care¹⁷17. Smart H, Opinion FB, Darwich I, Elnawasany MA, Kodange C. Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements. Adv Skin Wound Care. 2020;33(8):418-27. doi: https://doi.org/10.1097/01.ASW.0000669920.94084.c1 https://doi.org/10.1097/01.ASW.000066992... .
- Fit the N95 mask correctly by fixing the clip and add a surgical mask for alignment²²22. Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020 Jun 12;99(24):e20603. doi: https://doi.org/10.1097/MD.0000000000020603 https://doi.org/10.1097/MD.0000000000020... .
- Use a protective ear strap attached to the mask elastic²³23. Shanshal M, Ahmed HS, Asfoor H, Salih RI, Ali SA, Aldabouni YK. Impact of COVID-19 on medical practice: A nationwide survey of dermatologists and health care providers in Iraq. Clin Dermatol. 2020. doi: https://doi.org/10.1016/j.clindermatol.2020.11.010 https://doi.org/10.1016/j.clindermatol.2... .
Recommendations for the prevention of injuries related to the use of gloves and protective clothing
- Wash hands with soap, detergent, soaps or light oils, without perfume and with the least number of preservatives, dry them well and apply talc powder to the hands and feet before putting on gloves and boots, in order to protect the skin from friction and excessive hydration. If the gloves are dry, do not put too much talc powder on them²²22. Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020 Jun 12;99(24):e20603. doi: https://doi.org/10.1097/MD.0000000000020603 https://doi.org/10.1097/MD.0000000000020... .
- Apply specific hand cream regularly and avoid wearing gloves for a long time. Wearing cotton gloves or a layer of plastic gloves inside latex gloves helps protect against itching or irritation in people with a latex allergy²¹21. Jiang Q, Liu Y, Wei W, Zhu D, Chen A, Liu H, et al. The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID-19 in China: A multicentre cross-sectional survey. Int Wound J. 2020;17:1300-9. doi: https://doi.org/10.1111/iwj.13391 https://doi.org/10.1111/iwj.13391... .
- Apply a barrier cream before and after using PPE to prevent skin flaking and dryness²⁸28. Jiang Q, Song S, Zhou J, Liu Y, Chen A, et al. 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 Advances in Wound Care. 2020;9(7):357-64. doi: https://doi.org/10.1089/wound.2020.1212 https://doi.org/10.1089/wound.2020.1212... ^-²⁹29. Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther. 2020;33(6):e14346. doi: https://doi.org/10.1111/dth.14346 https://doi.org/10.1111/dth.14346... .

[1] *Corresponding author: Lívia Maia Pascoal E-mail: livia_mp@hotmail.com

Brasil

Brasil

Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review

Abstract

Objective

Method

Results

Conclusion