Verbeek JH, Rajamaki B, Ijaz S, et al. Cochrane Database Syst Rev. 2020
This Cochrane review evaluated the differential impacts of personal protective equipment (PPE) types and methods of donning/doffing on contamination and infection risk for healthcare workers. The authors included 24 studies (14 randomized controlled trials) representing over 2,200 patients. The authors found that PPE covering more body surface area may lead to better protection but at the cost of more difficult donning or doffing – for example, a powered, air-purifier respirator may protect against contamination better than a N95 mask and gown but with less compliance with donning. PPE design modifications may decrease the risk of contamination compared to standard PPE (e.g. better fit around neck, writes and hands). Certain donning and doffing procedures, such as following CDC doffing guidance, may reduce contamination and increase compliance. The authors note that simulation studies exploring which combinations of PPE and specific donning/doffing procedures protect best again contamination are warranted.
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