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Respirator (N95) masks, surgical masks, and single-use masks constitute the three tiers of facial masks currently in use. This comprehensive review discusses the classification of masks, the anatomy and critical issues of disinfection by heat, chemicals, or radiation, and reusability of masks. Alternative equipment available for protection of the facial region from airborne disease, including face shields and powered air-purifying respirators are discussed in terms of risks/benefits. Decubitus lesions caused by pressure of tight-fitting masks at the nasal bridge may be mitigated by application of protective hydrocolloid dressings over the area.
While surgical masks and N95 respirators were designed to be discarded after a single use, during the current PPE shortage, steam heat disinfection of these devices provides a balance between decontamination and maintaining an acceptable degree of integrity and filtering capacity for their re-use. Healthcare systems were unprepared for the COVID-19 pandemic, and, as we may be on the verge of further impending pandemics, scientists would be wise to proactively develop masks that have reusable potential.
We live in extraordinary times, where COVID-19 pandemic has brought the whole world to a screeching halt. Tensions and contradictions that surround the pandemic ridden world include the availability, and the lack thereof, various facial protection measures to mitigate the viral spread. Here, we comprehensively explore the different types of facial protection measures, including masks, needed both for the public and the healthcare workers (HCW). We discuss the anatomy, the critical issues of disinfection and reusability of masks, the alternative equipment available for the protection of the facial region from airborne diseases, such as face shields and powered air-purifying respirators (PAPR), and the skin health impact of prolonged wearing of facial protection by HCW. Clearly, facial protection, either in the form of masks or alternates, appears to have mitigated the pandemic as seen from the minimal COVID-19 spread in countries where public mask wearing is strictly enforced. On the contrary, the healthcare systems, that appear to have been unprepared for emergencies of this nature, should be appropriately geared to handle the imbalance of supply and demand of personal protective equipment including face masks. These are two crucial lessons we can learn from this tragic experience.