12/04/2020    Steven Kravitz, DPM

Medical Face Masks:An Overview for General Usage and Simple Guidelines

Editor’s Note: This article appeared in the
Academy of Professionals in Wound Healing (APWH)
Thanksgiving weekend newsletter and reflects
current data through October 2020.

Medical facemasks including the N95 are
considered the best overall. But access to them
can be difficult. Facemasks that contain valves
protect from inhalation but not against
exhalation and are now becoming banned in some
commercial centers because of increased potential
transmission. Facemasks with elastic properties
that stretch have not been identified with
satisfactory filtration for small particles and
are not recommended. There has been increased
attention recently for cotton facemasks.

If using cotton, it is suggested that 600 threads
per square inch is needed to be most effective
and should be multi-layered. Three layers
probably would be best. If you or a friend can
make these note that pillowcases and bedsheets
packaging normally have the fiber count which is
not often available on the facemask packaging.
Fabric facemasks are to be washed frequently and
should be washed before usage as many of these
contain chemicals that are used for shipping and
are removed with simple washing machine. White
cotton avoids the use of dies and other products
as well.

Paper-based surgical facemasks are inexpensive
and disposable. They provide satisfactory
protection for inhaled and exhaled small
particles --- but the important word to note here
is “disposable”. They are intended for single
usage and should be discarded after long-term
usage especially if they should become soiled as
well.

Masks of course must be adjusted to fit securely
and seal as best possible around the shape of the
face, around the nose and below the eyes, around
the side of the face and below the chin.
Independent of how the fabric may or not
sufficiently filter out small particles, the most
common problem is ill-fitting and improper
application. If you wear glasses and you find
they are fogging up with the use of your mask
than is not fitted properly and should be
adjusted.

Another aspect with all of this not often talked
about is what is inhaled into the lungs from
particles that might be dislodged from some of
the masks. There has been recent reported
literature of some pulmonary reactions being
attributed to the use of facemasks. I have not
seen any doubled-blind studies and of course time
will tell how much of a problem that is; but my
own personal view is you should be cautious about
that as well. If you feel fibers around your face
from any mask be aware that smaller fibers may
becoming inhaled and especially if these are
synthetic may become problematic.

Suggested resources for further reading:
CDC -- Centers for Disease Control and
Prevention : COVID-19: Considerations for
Wearing Masks | CDC ---- www.cdc.gov › 2019-
ncov › cloth-face-cover-guidance; How to Select,
Wear, and Clean Your Mask Updated Oct. 29, 2020

Steven Kravitz, DPM, Winston Salem, NC

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