Indications for accurate and appropriate use of personal protective equipment for healthcare professionals. A systematic review

ABSTRACT BACKGROUND: The speed of the spread of coronavirus disease 2019 (COVID-19) has put enormous pressure on hospitals and other healthcare facilities. This, together with blockages in several countries, has hindered the availability and accessibility of the necessary personal protective equipment (PPE). OBJECTIVE: To identify, systematically evaluate and summarize the available scientific evidence on the efficacy, safety, safe use and reuse of PPE for healthcare professionals, for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN AND SETTING: Systematic review of studies analyzing products for disinfecting and enabling reuse of PPE for coronavirus within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science and LILACS databases, for articles published up to November 30, 2020. RESULTS: Ten studies were selected. These analyzed the use of N95, surgical and cotton masks, face shields, flexible enclosures with plastic covers or polycarbonate intubation boxes and plastic curtains; and also PPE disinfection using several substances. CONCLUSION: Combined use of a face shield with a N95 mask proved to be superior to other associations for protecting healthcare workers. Some products are useful for disinfecting PPE, such as 70% ethanol, 0.1% sodium hypochlorite and a mixture of quaternary ammonium and H2O2, and hydrogen peroxide. Ultraviolet light and dry heat at 70 °C can be used to decontaminate N95 masks. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/4V5FD at the OPENSCIENCE Framework.

背景：2019冠状病毒病（COVID-19, Coronavirus Disease 2019）的传播速度给医院及其他医疗卫生机构带来了巨大压力。这一情况叠加多国防疫封锁措施，阻碍了必需个人防护装备（Personal Protective Equipment, PPE）的供应与可及性。
研究目的：系统识别、评价并总结现有科学证据，明确用于医护人员预防新型冠状病毒（Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2）感染的个人防护装备的功效、安全性、规范使用及复用方案。
研究设计与场景：本研究为系统综述，分析范畴涵盖巴西圣保罗州某联邦大学循证卫生项目内、针对冠状病毒相关个人防护装备消毒及复用策略的相关研究。
研究方法：于2020年11月30日前，在PubMed、EMBASE、Cochrane Library、CINAHL、SCOPUS、Web of Science及LILACS数据库中开展系统性文献检索。
研究结果：最终纳入10项研究，其分析对象包括N95口罩、外科口罩、棉布口罩、面屏、带塑料罩的柔性隔离装置或聚碳酸酯插管箱、塑料帘等个人防护装备，同时探讨了多种消毒物质的应用方案。
研究结论：面屏与N95口罩的联合使用方案，在保护医护人员方面的效果优于其他防护装备组合。部分物质可用于个人防护装备消毒，例如70%乙醇、0.1%次氯酸钠、季铵盐与过氧化氢（H₂O₂）的混合制剂以及过氧化氢本身。紫外线照射及70℃干热环境可用于N95口罩的消毒灭菌。
注册编号：开放科学框架（Open Science Framework, OSF）下的DOI：10.17605/OSF.IO/4V5FD。