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537		.learndash-wrapper .ld-focus-comments .comment-respond a,
538		.learndash-wrapper .ld-focus-comment .ld-comment-reply a.comment-reply-link:hover,
539		.learndash-wrapper .ld-expand-button.ld-button-alternate {
540			color: #1e2a54 !important;
541		}
542
543		.learndash-wrapper .ld-focus-comment.bypostauthor>.ld-comment-wrapper,
544		.learndash-wrapper .ld-focus-comment.role-group_leader>.ld-comment-wrapper,
545		.learndash-wrapper .ld-focus-comment.role-administrator>.ld-comment-wrapper {
546			background-color:rgba(30, 42, 84, 0.03) !important;
547		}
548
549
550		.learndash-wrapper .ld-primary-background,
551		.learndash-wrapper .ld-tabs .ld-tabs-navigation .ld-tab.ld-active:after {
552			background: #1e2a54 !important;
553		}
554
555
556
557		.learndash-wrapper .ld-course-navigation .ld-lesson-item.ld-is-current-lesson .ld-status-incomplete,
558		.learndash-wrapper .ld-focus-comment.bypostauthor:not(.ptype-sfwd-assignment) >.ld-comment-wrapper>.ld-comment-avatar img,
559		.learndash-wrapper .ld-focus-comment.role-group_leader>.ld-comment-wrapper>.ld-comment-avatar img,
560		.learndash-wrapper .ld-focus-comment.role-administrator>.ld-comment-wrapper>.ld-comment-avatar img {
561			border-color: #1e2a54 !important;
562		}
563
564
565
566		.learndash-wrapper .ld-loading::before {
567			border-top:3px solid #1e2a54 !important;
568		}
569
570		.learndash-wrapper .ld-button:hover:not(.learndash-link-previous-incomplete):not(.ld-button-transparent),
571		#learndash-tooltips .ld-tooltip:after,
572		#learndash-tooltips .ld-tooltip,
573		.learndash-wrapper .ld-primary-background,
574		.learndash-wrapper .btn-join,
575		.learndash-wrapper #btn-join,
576		.learndash-wrapper .ld-button:not(.ld-button-reverse):n
576ot(.learndash-link-previous-incomplete):not(.ld-button-transparent),
577		.learndash-wrapper .ld-expand-button,
578		.learndash-wrapper .wpProQuiz_content .wpProQuiz_button:not(.wpProQuiz_button_reShowQuestion):not(.wpProQuiz_button_restartQuiz),
579		.learndash-wrapper .wpProQuiz_content .wpProQuiz_button2,
580		.learndash-wrapper .ld-focus .ld-focus-sidebar .ld-course-navigation-heading,
581		.learndash-wrapper .ld-focus .ld-focus-sidebar .ld-focus-sidebar-trigger,
582		.learndash-wrapper .ld-focus-comments .form-submit #submit,
583		.learndash-wrapper .ld-login-modal input[type='submit'],
584		.learndash-wrapper .ld-login-modal .ld-login-modal-register,
585		.learndash-wrapper .wpProQuiz_content .wpProQuiz_certificate a.btn-blue,
586		.learndash-wrapper .ld-focus .ld-focus-header .ld-user-menu .ld-user-menu-items a,
587		#wpProQuiz_user_content table.wp-list-table thead th,
588		#wpProQuiz_overlay_close,
589		.learndash-wrapper .ld-expand-button.ld-button-alternate .ld-icon {
590			background-color: #1e2a54 !important;
591		}
592
593		.learndash-wrapper .ld-focus .ld-focus-header .ld-user-menu .ld-user-menu-items:before {
594			border-bottom-color: #1e2a54 !important;
595		}
596
597		.learndash-wrapper .ld-button.ld-button-transparent:hover {
598			background: transparent !important;
599		}
600
601		.learndash-wrapper .ld-focus .ld-focus-header .sfwd-mark-complete .learndash_mark_complete_button,
602		.learndash-wrapper .ld-focus .ld-focus-header #sfwd-mark-complete #learndash_mark_complete_button,
603		.learndash-wrapper .ld-button.ld-button-transparent,
604		.learndash-wrapper .ld-button.ld-button-alternate,
605		.learndash-wrapper .ld-expand-button.ld-button-alternate {
606			background-color:transparent !important;
607		}
608
609		.learndash-wrapper .ld-focus-header .ld-user-menu .ld-user-menu-items a,
610		.learndash-wrapper .ld-button.ld-button-reverse:hover,
611		.learndash-wrapper .ld-alert-success .ld-alert-icon.ld-icon-certificate,
612		.learndash-wrapper .ld-alert-warning .ld-button:not(.learndash-link-previous-incomplete),
613		.learndash-wrapper .ld-primary-background.ld-status {
614			color:white !important;
615		}
616
617		.learndash-wrapper .ld-status.ld-status-unlocked {
618			background-color: rgba(30,42,84,0.2) !important;
619			color: #1e2a54 !important;
620		}
621
622		.learndash-wrapper .wpProQuiz_content .wpProQuiz_addToplist {
623			background-color: rgba(30,42,84,0.1) !important;
624			border: 1px solid #1e2a54 !important;
625		}
626
627		.learndash-wrapper .wpProQuiz_content .wpProQuiz_toplistTable th {
628			background: #1e2a54 !important;
629		}
630
631		.learndash-wrapper .wpProQuiz_content .wpProQuiz_toplistTrOdd {
632			background-color: rgba(30,42,84,0.1) !important;
633		}
634
635		.learndash-wrapper .wpProQuiz_content .wpProQuiz_reviewDiv li.wpProQuiz_reviewQuestionTarget {
636			background-color: #1e2a54 !important;
637		}
638		.learndash-wrapper .wpProQuiz_content .wpProQuiz_time_limit .wpProQuiz_progress {
639			background-color: #1e2a54 !important;
640		}
641		
642		.learndash-wrapper #quiz_continue_link,
643		.learndash-wrapper .ld-secondary-background,
644		.learndash-wrapper .learndash_mark_complete_button,
645		.learndash-wrapper #learndash_mark_complete_button,
646		.learndash-wrapper .ld-status-complete,
647		.learndash-wrapper .ld-alert-success .ld-button,
648		.learndash-wrapper .ld-alert-success .ld-alert-icon {
649			background-color: #1e2a54 !important;
650		}
651
652		.learndash-wrapper .wpProQuiz_content a#quiz_continue_link {
653			background-color: #1e2a54 !important;
654		}
655
656		.learndash-wrapper .course_progress .sending_progress_bar {
657			background: #1e2a54 !important;
658		}
659
660		.learndash-wrapper .wpProQuiz_content .wpProQuiz_button_reShowQuestion:hover, .learndash-wrapper .wpProQuiz_content .wpProQuiz_button_restartQuiz:hover {
661			background-color: #1e2a54 !important;
662			opacity: 0.75;
663		}
664
665		.learndash-wrapper .ld-secondary-color-hover:hover,
666		.learndash-wrapper .ld-secondary-color,
667		.learndash-wrapper .ld-focus .ld-focus-header .sfwd-mark-complete .learndash_mark_complete_button,
668		.learndash-wrapper .ld-focus .ld-focus-header #sfwd-mark-complete #learndash_mark_complete_button,
669		.learndash-wrapper .ld-focus .ld-focus-header .sfwd-mark-complete:after {
670			color: #1e2a54 !important;
671		}
672
673		.learndash-wrapper .ld-secondary-in-progress-icon {
674			border-left-color: #1e2a54 !important;
675			border-top-color: #1e2a54 !important;
676		}
677
678		.learndash-wrapper .ld-alert-success {
679			border-color: #1e2a54;
680			background-color: transparent !important;
681			color: #1e2a54;
682		}
683
684		.learndash-wrapper .wpProQuiz_content .wpProQuiz_reviewQuestion li.wpProQuiz_reviewQuestionSolved,
685		.learndash-wrapper .wpProQuiz_content .wpProQuiz_box li.wpProQuiz_reviewQuestionSolved {
686			background-color: #1e2a54 !important;
687		}
688
689		.learndash-wrapper .wpProQuiz_content  .wpProQuiz_reviewLegend span.wpProQuiz_reviewColor_Answer {
690			background-color: #1e2a54 !important;
691		}
692
693		
694		.learndash-wrapper .ld-alert-warning {
695			background-color:transparent;
696		}
697
698		.learndash-wrapper .ld-status-waiting,
699		.learndash-wrapper .ld-alert-warning .ld-alert-icon {
700			background-color: #1e2a54 !important;
701		}
702
703		.learndash-wrapper .ld-tertiary-color-hover:hover,
704		.learndash-wrapper .ld-tertiary-color,
705		.learndash-wrapper .ld-alert-warning {
706			color: #1e2a54 !important;
707		}
708
709		.learndash-wrapper .ld-tertiary-background {
710			background-color: #1e2a54 !important;
711		}
712
713		.learndash-wrapper .ld-alert-warning {
714			border-color: #1e2a54 !important;
715		}
716
717		.learndash-wrapper .ld-tertiary-background,
718		.learndash-wrapper .ld-alert-warning .ld-alert-icon {
719			color:white !important;
720		}
721
722		.learndash-wrapper .wpProQuiz_content .wpProQuiz_reviewQuestion li.wpProQuiz_reviewQuestionReview,
723		.learndash-wrapper .wpProQuiz_content .wpProQuiz_box li.wpProQuiz_reviewQuestionReview {
724			background-color: #1e2a54 !important;
725		}
726
727		.learndash-wrapper .wpProQuiz_content  .wpProQuiz_reviewLegend span.wpProQuiz_reviewColor_Review {
728			background-color: #1e2a54 !important;
729		}
730
731		
732/*# sourceURL=learndash-front-inline-css */
733</style>
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Implementation of best practice guidance across healthcare settings remains inconsistent, influenced by terminology confusion, gaps in dissemination and competing clinical pressures.\r\nAim: To explore clinicians’ perceptions and use of the 2025 MASD Best Practice Statement, identify barriers and facilitators to its implementation.  \r\nMethods: A qualitative study using semi-structured interviews was conducted with 13 clinicians from acute, community, teaching and specialist services. Interviews were recorded, transcribed and analysed using reflexive thematic analysis to identify patterns of meaning. 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1149					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/understanding-the-factors-influencing-clinicians-adoption-of-moisture-associated-skin-damage-masd-best-practice-guidance-a-qualitative-interview-study/"><a href="https://wounds-uk.com/journal_issue/vol-22-issue-03/" rel="tag">Vol: 22 | Issue: 03</a></a></p>				</div>
1150				</div>
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1156				<div class="elementor-widget-container">
1157					<h1 class="elementor-heading-title elementor-size-default">Understanding the factors influencing clinicians’ adoption of Moisture-Associated Skin Damage (MASD) Best Practice Guidance: A qualitative interview study</h1>				</div>
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1246					<h1 class="elementor-heading-title elementor-size-default">Understanding the factors influencing clinicians’ adoption of Moisture-Associated Skin Damage (MASD) Best Practice Guidance: A qualitative interview study</h1>				</div>
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1250					<div class="dce-acf-repeater"><span class="repeater-item elementor-repeater-item-40604b1">Karen Ousey</span></div>				</div>
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1253				<div class="elementor-widget-container">
1254									18 September 2026								</div>
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1266									Background: Moisture-associated skin damage (MASD) is increasingly recognised as a significant cause of patient harm, and the 2025 Best Practice Statement was developed to support clinicians in identifying, preventing and managing it. Implementation of best practice guidance across healthcare settings remains inconsistent, influenced by terminology confusion, gaps in dissemination and competing clinical pressures.
1267Aim: To explore clinicians’ perceptions and use of the 2025 MASD Best Practice Statement, identify barriers and facilitators to its implementation.  
1268Methods: A qualitative study using semi-structured interviews was conducted with 13 clinicians from acute, community, teaching and specialist services. Interviews were recorded, transcribed and analysed using reflexive thematic analysis to identify patterns of meaning. Participants included tissue viability nurses, specialist clinicians and generalist practitioners.
1269Results: Five themes were identified: (1) MASD terminology is widely misunderstood, with many clinicians equating MASD solely with incontinence-associated dermatitis; (2) best practice documents are valued but underused due to time pressures and document length; (3) dissemination beyond specialist teams is limited and inconsistent, resulting in siloed knowledge; (4) clinical practice is often driven by experience rather than evidence-based guidance; and (5) there is strong demand for simplified, visual and layered resources to support rapid decision-making. 
1270Conclusion: Implementation of the MASD best practice guidance is often hindered by terminology confusion, education gaps and fragmented dissemination processes. Strengthening organisational support, enhancing multidisciplinary education and developing accessible, visual resources are essential to improving MASD recognition and promoting consistent, evidence-based care.								</div>
1271				</div>
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1286					
1287<p class="wp-block-paragraph">This article presents findings from semi-structured interviews with healthcare professionals and explores the factors that support or hinder clinicians in implementing the 2025 MASD Best Practice Statement within clinical settings.</p>
1288
1289
1290
1291<p class="wp-block-paragraph"><br>MASD is an umbrella term used to describe skin damage that occurs when the skin is exposed to excessive or prolonged moisture. It has gained recognition in the International Classification of Diseases (ICD) 11th edition (ICD-11) under the umbrella of irritant contact dermatitis due to friction, sweating or contact with body fluids (code EK02.2; Best Practice Statement, 2025).</p>
1292
1293
1294
1295<p class="wp-block-paragraph"></p>
1296
1297
1298
1299<p class="wp-block-paragraph">There are four categories of MASD:</p>
1300
1301
1302
1303<p class="wp-block-paragraph"></p>
1304
1305
1306
1307<ul class="wp-block-list">
1308<li>Incontinence-associated dermatitis (IAD)</li>
1309
1310
1311
1312<li>Peristomal complications associated with colostomy, gastrostomy (PEG tube), ileostomy/ileal conduit, urostomy, suprapubic catheter or tracheostomy</li>
1313
1314
1315
1316<li>
1316Intertriginous dermatitis (intertrigo) where two skin areas touch or rub together</li>
1317
1318
1319
1320<li>Periwound moisture-associated dermatitis (Best Practice Statement, 2025).</li>
1321</ul>
1322
1323
1324
1325<p class="wp-block-paragraph"></p>
1326
1327
1328
1329<p class="wp-block-paragraph">This moisture may come from urine, faeces, wound exudate, sweat, saliva or other bodily fluids. When the skin remains wet for too long, it becomes softer, more fragile and more vulnerable to damage.</p>
1330
1331
1332
1333<p class="wp-block-paragraph"><br>The 2025 Best Practice Statement, Understanding Types of Moisture-Associated Skin Damage (MASD): Prevention, Identification and Management, was published in November 2025 to support healthcare professionals in the early recognition, assessment and treatment of MASD. Best practice documents are intended to help clinicians deliver care that is consistent, evidence-based and aligned with recommended standards.</p>
1334
1335
1336
1337<p class="wp-block-paragraph"><br>Although clinical guidelines are widely valued as a source of support for decision-making, adherence remains variable across healthcare settings and clinical conditions (Milchak et al., 2004; van de Klundert et al., 2010). Whether guidance is accepted and used depends on a range of factors (Smith et al., 2019), including the behaviour of clinicians and patients, as well as organisational influences. These influences may reflect healthcare professionals’ knowledge and skills, or an organisation’s ability to gather, adapt, disseminate and apply evidence effectively (Kilsdonk et al., 2017). As a result, developing high-quality guidance alone does not guarantee that it will be used in routine care.</p>
1338
1339
1340
1341<p class="wp-block-paragraph"><br>Active and targeted implementation strategies are therefore required to support adoption in practice (Straus et al., 2009). In wound care, however, clinicians may face barriers to fully implementing guidance and, in some cases, may not even be aware that such best practice documents exist.</p>
1342
1343
1344
1345<p class="wp-block-paragraph"></p>
1346
1347
1348
1349<p class="wp-block-paragraph"><strong>Aims</strong><br>The aims of the study were to explore:<br></p>
1350
1351
1352
1353<ul class="wp-block-list">
1354<li>How best practice documents are perceived and used</li>
1355
1356
1357
1358<li>Specific attitudes towards the 2025 MASD Best Practice Statement</li>
1359
1360
1361
1362<li>Barriers and facilitators to implementation</li>
1363
1364
1365
1366<li>Opportunities to improve dissemination and engagement</li>
1367
1368
1369
1370<li>How MASD is understood, recognised and managed in real clinical practice.</li>
1371</ul>
1372
1373
1374
1375<p class="wp-block-paragraph"></p>
1376
1377
1378
1379<p class="wp-block-paragraph"><strong>Methodology<br></strong>Semi-structured interviews were conducted via Microsoft Teams and audio-recorded with consent by a trained researcher with qualitative research methods expertise. All recordings were stored on an encrypted server and deleted after data analysis. Analysis followed Braun and Clarke’s (2006) reflexive thematic analysis approach, which allowed themes to be developed iteratively and reflexively.Ethical approval was applied for and granted via the Research and Ethical Panel, OmniaMed Communications.<br></p>
1380
1381
1382
1383<p class="wp-block-paragraph"><strong>Data collection<br></strong>Purposive sampling was used to ensure representation from key opinion leaders and clinicians involved in the care of people with MASD. Email invitations, together with a participant information sheet and consent form, were sent to all participants before the interview, and additional clarification about the study was provided where needed. A mutually convenient time and date were agreed between the interviewer and interviewee.</p>
1384
1385
1386
1387<p class="wp-block-paragraph"><br>Participants represented acute hospitals, community services, teaching hospitals and specialist centres, including oncology, vascular and lymphoedema services. Although up to 15 participants were originally identified, data saturation was reached by participant 13. All data were stored on an encrypted secure server, and raw data were destroyed after transcription and analysis.</p>
1388
1389
1390
1391<p class="wp-block-paragraph"></p>
1392
1393
1394
1395<p class="wp-block-paragraph"><strong>Data analysis<br></strong>Interviews were transcribed by the interviewer, and reflexive thematic analysis (Braun and Clarke, 2006) w
1395as used to identify patterned meanings across the data. Interviews lasted 40 to 55 minutes. Five themes were identified.</p>
1396
1397
1398
1399<p class="wp-block-paragraph"></p>
1400
1401
1402
1403<p class="wp-block-paragraph"><strong>Themes</strong><br><strong>Theme 1: MASD terminology is misunderstood and a major barrier<br></strong>Participants explained that MASD is commonly associated with terms such as IAD, “moisture lesions” on the buttocks or general “bottom care”. This narrow understanding contributes to the perception that the MASD best practice document has limited relevance outside continence and skin integrity-related issues. As a result, several participants reported that the guidance is often viewed as unrelated to leg ulcer management, unsuitable for oncology settings and disconnected from lymphoedema care. This reinforces the assumption that MASD is not a recognised priority for the wider multidisciplinary workforce.</p>
1404
1405
1406
1407<p class="wp-block-paragraph"><br>Across all interviews, participants consistently emphasised that clinicians tend to equate MASD almost exclusively with IAD, overlooking the broader MASD spectrum. They noted that documentation templates rarely include MASD terminology and that MASD affecting skin folds, periwound areas, peristomal sites and lower limbs is frequently missed.<br>Participants also described confusion around terminology and coding, which can reduce visibility in records and create difficulty during governance reviews. Some suggested that clinicians avoid using MASD terminology because it may trigger extra reporting, or because current systems do not support it well.</p>
1408
1409
1410
1411<p class="wp-block-paragraph"><br>This misunderstanding leads to poor recognition, inconsistent documentation and inappropriate categorisation of moisture damage. Participants commented that:<br></p>
1412
1413
1414
1415<ul class="wp-block-list">
1416<li>Nurses immediately think of IAD when they hear MASD</li>
1417
1418
1419
1420<li>Periwound and peristomal MASD are rarely recognised</li>
1421
1422
1423
1424<li>MASD may be understood conceptually, but it is rarely documented</li>
1425
1426
1427
1428<li>Leg ulcer maceration is almost never labelled as MASD in practice.</li>
1429</ul>
1430
1431
1432
1433<p class="wp-block-paragraph"></p>
1434
1435
1436
1437<p class="wp-block-paragraph">It was interesting to note that only two participants highlighted they only recognised the relevance of MASD after reading the document in more depth. All participants noted that the emphasis on pressure ulcer prevention has contributed to a strong focus on IAD, particularly the need to explain that buttock damage is not necessarily a pressure ulcer.</p>
1438
1439
1440
1441<p class="wp-block-paragraph"><br>Many also felt that MASD can seem less relevant to staff in vascular, surgical, stoma, paediatric, oncology and lymphoedema services, as well as to teams outside tissue viability. This terminology gap was identified as the single most significant barrier to wider implementation.</p>
1442
1443
1444
1445<p class="wp-block-paragraph"></p>
1446
1447
1448
1449<p class="wp-block-paragraph">Despite these barriers, participants who engaged with the MASD document reported practical changes in care, including:<br></p>
1450
1451
1452
1453<ul class="wp-block-list">
1454<li>Rethinking the management of MASD around wounds</li>
1455
1456
1457
1458<li>Changing product selection</li>
1459
1460
1461
1462<li>Greater confidence in using dressings for severe moisture damage</li>
1463
1464
1465
1466<li>Improved assessment of mixed-aetiology MASD, including fungal, bacterial, sweat, lymphorrhoea and exudate-related causes.</li>
1467</ul>
1468
1469
1470
1471<p class="wp-block-paragraph"></p>
1472
1473
1474
1475<p class="wp-block-paragraph">Clinicians gave examples of cases in which the document changed decision-making, particularly around the use of enzyme alginogels (Flaminal®, Flen Health) for moderate to severe MASD, in cases where the risk of fungal infection is high, and when selecting other types of primary dressings. These accounts showed that the best practice document could influence real-world clinical practice when it was read and applied.</p>
1476
1477
1478
1479<p class="wp-block-paragraph"></p>
1480
1481
1482
1483<p class="wp-block-paragraph"><strong>Theme 2: Best practice documents are valued but sometimes underused<br></strong>Participants universally praised best practice documents as:<br></p>
1484
1485
1486
1487<ul class="wp-block-list">
1488<li>Evidence-based</li>
1489
1490
1491
1492<li>Helpful for training</li>
1493
1494
1495
1496<li>Useful for standardising care and supporting junior staff</li>
1497
1498
1499
1500<li>Concise compared with major guidelines</li>
1501
1502
1503
1504<li>TVNs and junior TVNs use them all the time.</li>
1505</ul>
1506
1507
1508
1509<p class="wp-block-paragraph">However, many participants felt that the documents are not read in full, particularly by time-pressured generalist staff, because they are often perceived as long PDF files. Common concerns included:<br></p>
1510
1511
1512
1513<ul class="wp-block-list">
1514<li>The documents are too long for busy clinical environments.</li>
1515
1516
1517
1518<li>Staff tend to skim only the sections relevant to them</li>
1519
1520
1521
1522<li>District nurses are unlikely to read them because of workload pressure</li>
1523
1524
1525
1526<li>Many clinicians only hear about new documents if someone explicitly tells them</li>
1527
1528
1529
1530<li>The content is good, but the length puts people off.</li>
1531</ul>
1532
1533
1534
1535<p class="wp-block-paragraph"></p>
1536
1537
1538
1539<p class="wp-block-paragraph">This creates an implementation gap. The documents exist, are freely available online and in hard copy, but they do not consistently influence everyday practice because awareness is limited outside tissue viability team
1539s, specialist wound care interests and academic settings.</p>
1540
1541
1542
1543<p class="wp-block-paragraph"></p>
1544
1545
1546
1547<p class="wp-block-paragraph"><strong>Theme 3: Dissemination beyond specialist teams is limited and inconsistent<br></strong>Dissemination was described as inconsistent, informal and largely dependent on a small number of motivated individuals. Many participants said they shared best practice documents during link nurse meetings or via the local intranet, but there was no formal organisational process for systematic distribution. As a result, generalist teams, care homes, general practitioners and allied health professionals often did not receive the documents, either because they were unaware of them or had not subscribed to relevant alerts.</p>
1548
1549
1550
1551<p class="wp-block-paragraph"></p>
1552
1553
1554
1555<p class="wp-block-paragraph">Participants highlighted that:<br></p>
1556
1557
1558
1559<ul class="wp-block-list">
1560<li>People do not know the documents exist unless someone tells them</li>
1561
1562
1563
1564<li>Dissemination efforts vary greatly between services</li>
1565
1566
1567
1568<li>A lack of cross-specialty sharing results in siloed knowledge</li>
1569
1570
1571
1572<li>Awareness remains local unless a tissue viability nurse actively promotes the document.</li>
1573</ul>
1574
1575
1576
1577<p class="wp-block-paragraph"></p>
1578
1579
1580
1581<p class="wp-block-paragraph">Many participants suggested that publishing houses should broaden their dissemination strategies to reach a wider multiprofessional audience, including medical staff, podiatrists, AHPs and others. They also proposed that best practice documents could be strengthened through endorsement by professional societies beyond those aligned with tissue viability, for example, the British Geriatrics Society, oncology organisations or continence related groups, to increase visibility and use. Additionally, several clinicians advocated for a more formal, cross-organisational dissemination process, comparable to the distribution of NICE guideline alerts, to ensure consistent awareness across clinical services.</p>
1582
1583
1584
1585<p class="wp-block-paragraph"><br>Most interviewees worked across multidisciplinary teams, but involvement and understanding of MASD varied widely. For example:</p>
1586
1587
1588
1589<p class="wp-block-paragraph"></p>
1590
1591
1592
1593<ul class="wp-block-list">
1594<li>Therapists (occupational therapists/physiotherapists) complete skin bundles in some organisations but not others</li>
1595
1596
1597
1598<li>Nutrition services contribute to skin health in certain pathways</li>
1599
1600
1601
1602<li>Lymphoedema and GP services often overlook MASD despite its high relevance</li>
1603
1604
1605
1606<li>Paramedics encounter MASD but have minimal formal training</li>
1607
1608
1609
1610<li>Oncology, haematology, plastics, radiography, orthopaedics and geriatrics are rarely included in dissemination efforts.</li>
1611
1612
1613
1614<li>Allied health professionals often require greater confidence and more comprehensive training to contribute effectively to MASD-related care</li>
1615
1616
1617
1618<li>Allied health professionals see MASD first but don’t feel able to assess it.</li>
1619</ul>
1620
1621
1622
1623<p class="wp-block-paragraph"></p>
1624
1625
1626
1627<p class="wp-block-paragraph">They also highlighted considerable regional variation in the degree of multidisciplinary team integration, noting that some areas benefit from cohesive collaboration while others experience fragmented working practices. Importantly, participants emphasised that earlier involvement of MDTs could help identify issues sooner and prevent deterioration demonstrating the value of proactive, coordinated assessment.</p>
1628
1629
1630
1631<p class="wp-block-paragraph"><br>The consensus from all interviews was that effective MASD management requires coordinated MDT awareness, but this is currently inconsistent and siloed.</p>
1632
1633
1634
1635<p class="wp-block-paragraph"></p>
1636
1637
1638
1639<p class="wp-block-paragraph"><strong>Theme 4: Clinical practice is driven by experience<br></strong>Several participants noted that the prevention of MASD is not consistently prioritised in clinical practice. They reported that clinicians frequently intervene only once tissue damage has become advanced, reflecting a tendency for healthy skin care to be undervalued and insufficiently resourced. Participants also highlighted that preventive strategies lack a compelling business case, largely because the benefits of avoided harm are difficult to quantify and therefore challenging to justify within current service pressures and funding models.</p>
1640
1641
1642
1643<p class="wp-block-paragraph"><br>Participants highlighted that much real-world MASD management is guided by clinical judgement, habit and product familiarity. They praised the MASD document’s inclusion of images showing diverse skin tones and that the visual
1643s strongly influenced engagement, especially among busy clinicians. Several participants described how reading the MASD document directly changed their practice, especially in cases involving multiple moisture sources, fungal components or complex lower limb wounds.</p>
1644
1645
1646
1647<p class="wp-block-paragraph"><br>Clinicians who had engaged with the MASD Best Practice Statement described several notable changes in their clinical practice. They reported increased confidence in selecting and using dressings for severe MASD, alongside a more systematic approach to categorising different MASD types. Participants also described enhanced ability to distinguish between fungal, sweat-related, exudate-related and urine-related skin damage.</p>
1648
1649
1650
1651<p class="wp-block-paragraph"><br>Across all interviews, education emerged as one of the strongest facilitators of adoption.Effective strategies include:</p>
1652
1653
1654
1655<p class="wp-block-paragraph"></p>
1656
1657
1658
1659<ul class="wp-block-list">
1660<li>Study days</li>
1661
1662
1663
1664<li>Ward-based teaching</li>
1665
1666
1667
1668<li>Regular MDT sessions</li>
1669
1670
1671
1672<li>E-learning modules</li>
1673
1674
1675
1676<li>Visual quick-reference resources</li>
1677
1678
1679
1680<li>Patient education materials.</li>
1681</ul>
1682
1683
1684
1685<p class="wp-block-paragraph"></p>
1686
1687
1688
1689<p class="wp-block-paragraph">The group consensus was that education bridges the gap between theory and practice, ensuring clinicians understand MASD beyond IAD and can apply guidance confidently.</p>
1690
1691
1692
1693<p class="wp-block-paragraph"></p>
1694
1695
1696
1697<p class="wp-block-paragraph"><strong>Theme 5: Strong need for simplified, visual, multi-format resources<br></strong>This emerged as one of the strongest and most unanimous themes. All participants recognised that the best practice documents were both much needed and highly valuable and they particularly welcomed the inclusion of myths and truths sections, algorithms and flowcharts.</p>
1698
1699
1700
1701<p class="wp-block-paragraph"><br></p>
1702
1703
1704
1705<p class="wp-block-paragraph">However, they also advocated for a range of layered, complementary resources, including:<br></p>
1706
1707
1708
1709<ul class="wp-block-list">
1710<li>One-page pathways</li>
1711
1712
1713
1714<li>Made Easy versions to accompany the best practice document, supported by a QR code linking to the full guidance</li>
1715
1716
1717
1718<li>Patient and carer information leaflets to facilitate distribution during clinics and home visits.</li>
1719</ul>
1720
1721
1722
1723<p class="wp-block-paragraph"></p>
1724
1725
1726
1727<p class="wp-block-paragraph">Participants stated:<br></p>
1728
1729
1730
1731<ul class="wp-block-list">
1732<li>One page of A4 – that’s what people will actually use</li>
1733
1734
1735
1736<li>Layered resources: full document + Made Easy + patient leaflet</li>
1737
1738
1739
1740<li>Visual tools support rapid decision-making</li>
1741
1742
1743
1744<li>AHPs and carers require simple, accessible explanations</li>
1745
1746
1747
1748<li>Layered tools help bridge knowledge gaps in overstretched teams.</li>
1749</ul>
1750
1751
1752
1753<p class="wp-block-paragraph"></p>
1754
1755
1756
1757<p class="wp-block-paragraph">One participant noted their trust had already created colour-coded, single-page MASD pathways because the full documents were too long for ward nurses to reliably use.</p>
1758
1759
1760
1761<p class="wp-block-paragraph"></p>
1762
1763
1764
1765<p class="wp-block-paragraph"><strong>Discussion</strong><br>The analysis revealed a tension; although best practice documents are widely regarded as credible and evidence-based, they do not consistently translate into routine clinical practice. This implementation gap appears to be driven by a series of underlying barriers, including limited dissemination of guidance across multiple clinical areas and specialties, significant time constraints within clinical workflows, persistent misconceptions with a narrow understanding of MASD and insufficient organisational support for implementation. Facilitating change into practice can be challenging but embedding implementation science methods can be useful. Implementation science is commonly described as the scientific study of methods to promote the systematic uptake of research f
1765indings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care (Eccles and Mittmann, 2006).</p>
1766
1767
1768
1769<p class="wp-block-paragraph"><br>Wensing and Grol (2019) exploring knowledge translation in health, highlighted that decades of research suggest individuals are more likely to engage with and apply interventions when they feel a sense of ownership over them and can adapt them to suit local circumstances and preferences with local ownership being critical for long-term sustainability (Rogers, 2003). </p>
1770
1771
1772
1773<p class="wp-block-paragraph">When teams are actively involved, they are better equipped to oversee implementation and adjust to evolving conditions such as new policies, shifts in funding, staffing changes or variations in the populations they serve (Chambers et al., 2013).</p>
1774
1775
1776
1777<p class="wp-block-paragraph"><br>The challenges faced in healthcare improvement substantially vary, for example, system-level considerations are likely to be decisive in the centralisation of services, whereas individual level factors such as clinicians’ habits, knowledge and behavioural patterns may be most influential in medication-related changes (Wensing and Grol, 2019). Strategies employed to manage change do not always align well with the nature of the problem. In practice, organisational or system-level barriers are often overlooked even when identified, with a tendency to favour individually focussed solutions such as educational or psychological interventions instead (Bosch et al., 2007).</p>
1778
1779
1780
1781<p class="wp-block-paragraph"><br>Wang et al. (2023), in their systematic review, highlight that effective use of clinical practice guidelines can provide substantial benefits for patients, clinicians and healthcare systems. These benefits include improved quality of care, reduced costs, decreased unwarranted variations in practice and fewer preventable errors and adverse events (Wang et al., 2023; Kredo et al., 2016). Providing sufficient education and training helps healthcare professionals understand the value of evidence-based recommendations, developing more positive attitudes towards guideline use. Increased familiarity with guideline content can strengthen clinicians’ confidence and promote higher adherence to recommended practices (Boltin et al., 2016). Enhanced knowledge and skills also support more productive discussions between clinicians and patients, which is essential for delivering high quality care and building therapeutic relationships. Digital technologies can facilitate these educational efforts by offering online learning materials and virtual training sessions, which are particularly useful for clinicians and patients who have limited access to face-to-face sessions.</p>
1782
1783
1784
1785<p class="wp-block-paragraph"><br>The recommendations generated through this study highlight the need for a coordinated, system-wide approach to improving implementation of best practice documents within wound care. Participants emphasised that barriers to implementation are not solely attributable to individual clinicians, but instead reflect structural, educational and organisational limitations. Strengthening accessibility and usability emerged as a key priority, with calls for publishers and authors to provide clearer, more concise resources including Made Easy summaries and one-page easy to read and understand overviews of documents which can be given to patients and their families/carers.</p>
1786
1787
1788
1789<p class="wp-block-paragraph"><br>At the clinical team level, particularly within Tissue Viability and Wound Care services, proactive dissemination strategies, enhanced education on MASD, including clarification of its four subtypes and the development of localised care pathways were seen as essential mechanisms for improving consistency of practice. Organisational and ICB level actions were also viewed as integral to closing the evidence-practice gap; embedding MASD training into mandatory programmes, structured review processes and promoting cross-specialty engagement were identified as strategies that could reinforce accountability and ensure sustained implementation. Finally, the incorporation of MASD and best practice guidance into undergraduate nursing and AHPs curricula was regarded as critical for establishing foundational competence and avoiding misconceptions, particularly the tendency to view MASD solely with IAD.</p>
1790
1791
1792
1793<p class="wp-block-paragraph"></p>
1794
1795
1796
1797<p class="wp-block-paragraph"><strong>What can be undertaken in practice to make a difference?<br></strong>The interviews indicated that best practice documents are valued as important educational and clinical resources; however, a number of barriers limit their effective implementation and the evaluation of associated outcomes. To address these challenges a series of practical strategies aimed at enhancing knowledge, clinical skills and patient outcomes in the management of MASD are presented below including:</p>
1798
1799
1800
1801<p class="wp-block-paragraph"></p>
1802
1803
1804
1805<ul class="wp-block-list">
1806<li>Engaging with local and neighbouring teams to adapt existing pathways to the local context, to avoid duplication of effort</li>
1807
1808
1809
1810<li>Adoption of a phased implementation approach, beginning with pilot wards or teams prior to broader rollout, enables identification and resolution of practical challenges before wider dissemination</li>
1811
1812
1813
1814<li>Identification of clinical champions to lead adoption of tools and educational initiatives, ensuring that responsibility is not solely placed on tissue viability nurses, lead wound care nurses or lymphoedema specialists</li>
1815
1816
1817
1818<li>Establishing clarity and consistency in terminology through the development of glossaries and targeted training is essential to supp
1818ort accurate identification and reporting of MASD</li>
1819
1820
1821
1822<li>Implementation of multidisciplinary educational initiatives to enhance awareness and understanding of MASD across all relevant professional groups</li>
1823
1824
1825
1826<li>Collaboration with industry partners may provide valuable support in the development of business cases, delivery of quality improvement initiatives and provision of educational resources.</li>
1827</ul>
1828
1829
1830
1831<p class="wp-block-paragraph"></p>
1832
1833
1834
1835<p class="wp-block-paragraph">Collectively, these approaches offer a pragmatic framework to support effective translation of best practice guidance into routine clinical care.</p>
1836
1837
1838
1839<p class="wp-block-paragraph"></p>
1840
1841
1842
1843<p class="wp-block-paragraph"><strong>Future considerations<br></strong>Future research should focus on practical, clinically relevant questions that support prevention and management of MASD. There is a need for longer term follow up to assess sustained skin integrity and recurrence of MASD. Economic evaluations would support clinicians and services to demonstrate the value of prevention including reduced rates of severe MASD and fewer escalations to specialist care. Further work is needed to evaluate whether simplified, layered resources (such as Made Easy summaries and one-page tools aimed at patients and carers) improve understanding, confidence and consistency of practice. Research exploring the impact of embedding MASD education into mandatory training and undergraduate nursing and allied health curricula is essential to address ongoing misconceptions, particularly the tendency to view MASD only as IAD. Finally, studies examining effective dissemination strategies, multidisciplinary collaboration and patient and carer experiences would support more consistent, proactive MASD care across acute, community, primary care and care home settings.</p>
1844
1845
1846
1847<p class="wp-block-paragraph"></p>
1848
1849
1850
1851<p class="wp-block-paragraph"><strong>Conclusion</strong><br>This study revealed barriers to the use of the MASD best practice document, stemming from misinterpretation of MASD and challenging dissemination infrastructure. Despite these challenges, clinicians value the document and express a strong desire for layered, accessible resources that can be integrated into everyday care across diverse settings. It highlights a clear opportunity of strengthening education, improving dissemination pathways, expanding MDT involvement and creating simplified, visual tools which can enhance MASD recognition and management.</p>
1852
1853
1854
1855<p class="wp-block-paragraph"><strong>Acknowledgements</strong><br><em>I would like to thank all participants for their time, expertise and honesty. Your engagement made this study achievable.</em></p>
1856
1857
1858
1859<p class="wp-block-paragraph"></p>
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1868									<strong>Disclaimer:  </strong>The article has been supported by an educational grant from Flen Health®. Flen Health® had no input into the study design, data collection or data analysis. 								</div>
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1872									<strong>References</strong><p>Best Practice Statement (2025) Understanding types of Moisture-Associated skin damage (MASD): prevention, identification and management. London: Woun
1872ds UK. Available to download from: <a href="http://www.wounds-uk.com">www.wounds-uk.com</a></p>
1873<p>Boltin D, Kimchi N, Dickman R, et al (2016) Attitudes and practice related to Helicobacter pylori infection among primary care physicians. Eur J Gastroenterol Hepatol 28:1035–40.</p>
1874<p>Bosch M, Van der Weijden T, Wensing M, Grol R. Tailoring quality improvement interventions to identified barriers: a multiple case analysis. J Eval Clin Pract. 2007;13:161–8.</p>
1875<p>Braun, V., &amp; Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. <a href="https://doi.org/10.1191/1478088706qp063oa">https://doi.org/10.1191/1478088706qp063oa</a></p>
1876<p>Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8(1):117. <a href="https://doi.org/10.1186/1748-5908-8-117">https://doi.org/10.1186/1748-5908-8-117</a>.</p>
1877<p>Eccles MP, Mittman BS. Welcome to Implementation Science. Implement Sci. 2006;1:1.</p>
1878<p>Kilsdonk E, Peute LW, Jaspers MWM. Factors influencing implementation success of guideline-based clinical decision support systems: a systematic review and gaps analysis. Int J Med Inform. 2017;98:56–64</p>
1879<p>Kredo T, Bernhardsson S, Machingaidze S, et al. Guide to clinical practice guidelines: the current state of play. Int J Qual Health Care 2016;28:122–8.</p>
1880<p>Milchak JL, Carter BL, James PA, Ardery G. Measuring adherence to practice guidelines for the management of hypertension: an evaluation of the literature. Hypertension. 2004;44(5):602–8.</p>
1881<p>Rogers EM. Diffusion of innovations. New York: Free Press; 2003.</p>
1882<p>Straus SE, Tetroe J, Graham ID. Knowledge translation in health care: moving from evidence to practice. 2nd ed. Chichester, UK: Wiley-Blackwell/ BMJ; 2009. p. 1–318.</p>
1883<p>van de Klundert J, Gorissen P, Zeemering S. Measuring clinical pathway adherence. J Biomed Inform. 2010;43(6):861–72.</p>
1884<p>Wang T, Tan J-YB, Liu X- L, et al. Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews. BMJ Open 2023;13:e062158. doi:10.1136/ bmjopen-2022-062158</p>
1885<p>Wensing, M., Grol, R. Knowledge translation in health: how implementation science could contribute more. BMC Med 17, 88 (2019). <a href="https://doi.org/10.1186/s12916-019-1322-9">https://doi.org/10.1186/s12916-019-1322-9</a></p>
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1996							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
1997										<span class="elementor-icon-list-text">Consensus documents</span>
1998											</a>
1999									</li>
2000								<li class="elementor-icon-list-item">
2001											<a href="/category/how-to-guides/">
2002
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2004							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2005										<span class="elementor-icon-list-text">How to guides</span>
2006											</a>
2007									</li>
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2009											<a href="/category/made-easy/">
2010
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2012							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2013										<span class="elementor-icon-list-text">Made Easy</span>
2014											</a>
2015									</li>
2016								<li class="elementor-icon-list-item">
2017											<a href="/category/making-the-case/">
2018
2019												<span class="elementor-icon-list-icon">
2020							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2021										<span class="elementor-icon-list-text">Making the case</span>
2022											</a>
2023									</li>
2024								<li class="elementor-icon-list-item">
2025											<a href="/category/explained-series/">
2026
2027												<span class="elementor-icon-list-icon">
2028							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2029										<span class="elementor-icon-list-text">Explained series</span>
2030											</a>
2031									</li>
2032								<li class="elementor-icon-list-item">
2033											<a href="/category/patient-partnership/">
2034
2035												<span class="elementor-icon-list-icon">
2036							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2037										<span class="elementor-icon-list-text">Patient partnership</span>
2038											</a>
2039									</li>
2040								<li class="elementor-icon-list-item">
2041											<a href="/category/supplements/">
2042
2043												<span class="elementor-icon-list-icon">
2044							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2045										<span class="elementor-icon-list-text">Supplements</span>
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2049											<a href="/category/quick-guides/">
2050
2051												<span class="elementor-icon-list-icon">
2052							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2053										<span class="elementor-icon-list-text">Quick guides</span>
2054											</a>
2055									</li>
2056								<li class="elementor-icon-list-item">
2057											<a href="/category/videos/">
2058
2059												<span class="elementor-icon-list-icon">
2060							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2061										<span class="elementor-icon-list-text">Videos</span>
2062											</a>
2063									</li>
2064								<li class="elementor-icon-list-item">
2065											<a href="/abstracts/">
2066
2067												<span class="elementor-icon-list-icon">
2068							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
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2070											</a>
2071									</li>
2072								<li class="elementor-icon-list-item">
2073											<a href="/podcasts/">
2074
2075												<span class="elementor-icon-list-icon">
2076							<i aria-hidden="true" class="fas fa-circle"></i>						</span>
2077										<span class="elementor-icon-list-text">Podcasts</span>
2078											</a>
2079									</li>
2080						</ul>
2081						</div>
2082				</div>
2083					</div>
2084		</div>
2085					</div>
2086		</section>
2087				</div>
2088		</div>
2089						</div>
2090				</div>
2091					</div>
2092		</div>
2093					</div>
2094		</section>
2095				<section data-dce-background-color="#EAEAEA" class="elementor-section elementor-top-section elementor-element elementor-element-0160b1c elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="0160b1c" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
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2098			<div class="elementor-widget-wrap elementor-element-populated">
2099						<div data-dce-text-color="#FFFFFF" data-dce-advanced-background-color="#579ED8" class="elementor-element elementor-element-7a3d7e9 elementor-widget__width-auto elementor-widget elementor-widget-text-editor" data-id="7a3d7e9" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default">
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2101									Related content								</div>
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2111					</a>
2112				</div>
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2114				</div>
2115				<div class="elementor-element elementor-element-99e9491 elementor-grid-4 elementor-grid-tablet-3 elementor-posts--thumbnail-top elementor-grid-mobile-1 elementor-widget elementor-widget-posts" data-id="99e9491" data-element_type="widget" data-e-type="widget" data-settings="{&quot;custom_columns&quot;:&quot;4&quot;,&quot;custom_columns_tablet&quot;:&quot;3&quot;,&quot;custom_row_gap_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:20,&quot;sizes&quot;:[]},&quot;custom_row_gap_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:20,&quot;sizes&quot;:[]},&quot;custom_columns_mobile&quot;:&quot;1&quot;,&quot;custom_row_gap&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:35,&quot;sizes&quot;:[]}}" data-widget_type="posts.custom">
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2118      		<article id="post-25031" class="elementor-post elementor-grid-item ecs-post-loop post-25031 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-clinical-skills tag-learning tag-patient-safety tag-practice-development tag-staff-confidence journal_issue-vol-22-issue-03">
2119				<div data-elementor-type="loop" data-elementor-id="227" class="elementor elementor-227 elementor-location-single post-25031 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-clinical-skills tag-learning tag-patient-safety tag-practice-development tag-staff-confidence journal_issue-vol-22-issue-03" data-elementor-post-type="elementor_library">
2120					<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-top-section elementor-element elementor-element-0115ef3 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="0115ef3" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2121						<div class="elementor-container elementor-column-gap-default">
2122					<div data-dce-background-color="#FFFFFF" class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0bfc1f1" data-id="0bfc1f1" data-element_type="column" data-e-type="column" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2123			<div class="elementor-widget-wrap elementor-element-populated">
2124						<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-inner-section elementor-element elementor-element-bd2ecbc elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="bd2ecbc" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2125						<div class="elementor-container elementor-column-gap-default">
2126					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-eaefff7" data-id="eaefff7" data-element_type="column" data-e-type="column">
2127			<div class="elementor-widget-wrap elementor-element-populated">
2128						<div class="elementor-element elementor-element-aa93fc7 elementor-widget elementor-widget-theme-post-featured-image elementor-widget-image" data-id="aa93fc7" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-featured-image.default">
2129				<div class="elementor-widget-container">
2130																<a href="https://wounds-uk.com/journal-articles/building-specialist-capability-developing-a-proficiency-based-induction-for-tissue-viability-services/">
2131							<img width="2560" height="1707" src="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-scaled.jpg" class="attachment-full size-full wp-image-25033" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-scaled.jpg 2560w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-300x200.jpg 300w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-1024x683.jpg 1024w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-768x512.jpg 768w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-1536x1024.jpg 1536w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-2048x1365.jpg 2048w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-karola-g-5206922-600x400.jpg 600w" sizes="(max-width: 2560px) 100v
2131w, 2560px" />								</a>
2132															</div>
2133				</div>
2134				<div class="elementor-element elementor-element-ccccf91 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="ccccf91" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-title.default">
2135				<div class="elementor-widget-container">
2136					<h2 class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/building-specialist-capability-developing-a-proficiency-based-induction-for-tissue-viability-services/">Building specialist capability: Developing a proficiency-based induction for tissue viability services</a></h2>				</div>
2137				</div>
2138				<div class="elementor-element elementor-element-97e7cc4 elementor-widget elementor-widget-heading" data-id="97e7cc4" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default">
2139				<div class="elementor-widget-container">
2140					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/building-specialist-capability-developing-a-proficiency-based-induction-for-tissue-viability-services/">A structured induction programme helps new tissue viability staff develop specialist skills, confidence and clinical reasoning, supporting safer wound care.</a></p>				</div>
2141				</div>
2142					</div>
2143		</div>
2144					</div>
2145		</section>
2146				<section data-dce-background-color="#1E2A54" class="elementor-section elementor-inner-section elementor-element elementor-element-9f0d636 elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="9f0d636" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2147						<div class="elementor-container elementor-column-gap-default">
2148					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-124b6fb" data-id="124b6fb" data-element_type="column" data-e-type="column" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2149			<div class="elementor-widget-wrap elementor-element-populated">
2150						<div data-dce-title-color="#FFFFFF" class="elementor-element elementor-element-2d01e43 elementor-widget elementor-widget-heading" data-id="2d01e43" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default">
2151				<div class="elementor-widget-container">
2152					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/building-specialist-capability-developing-a-proficiency-based-induction-for-tissue-viability-services/">18 September 2026</a></p>				</div>
2153				</div>
2154					</div>
2155		</div>
2156					</div>
2157		</section>
2158					</div>
2159		</div>
2160					</div>
2161		</section>
2162				</div>
2163				</article>
2164				<article id="post-25026" class="elementor-post elementor-grid-item ecs-post-loop post-25026 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-cardiac-surgery tag-postoperative-wound-care tag-practice-development tag-surgical-site-infection journal_issue-vol-22-issue-03">
2165				<div data-elementor-type="loop" data-elementor-id="227" class="elementor elementor-227 elementor-location-single post-25026 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-cardiac-surgery tag-postoperative-wound-care tag-practice-development tag-surgical-site-infection journal_issue-vol-22-issue-03" data-elementor-post-type="elementor_library">
2166					<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-top-section elementor-element elementor-element-0115ef3 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="0115ef3" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2167						<div class="elementor-container elementor-column-gap-default">
2168					<div data-dce-background-color="#FFFFFF" class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0bfc1f1" data-id="0bfc1f1" data-element_type="column" data-e-type="column" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2169			<div class="elementor-widget-wrap elementor-element-populated">
2170						<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-inner-section elementor-element elementor-element-bd2ecbc elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="bd2ecbc" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2171						<div class="elementor-container elementor-column-gap-default">
2172					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-eaefff7" data-id="eaefff7" data-element_type="column" data-e-type="column">
2173			<div class="elementor-widget-wrap elementor-element-populated">
2174						<div class="elementor-element elementor-element-aa93fc7 elementor-widget elementor-widget-theme-post-featured-image elementor-widget-image" data-id="aa93fc7" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-featured-image.default">
2175				<div class="elementor-widget-container">
2176																<a href="https://wounds-uk.com/journal-articles/targeted-postoperative-wound-care-kits-delivered-as-part-of-digital-surgical-site-infection-surveillance-after-cardiac-surgery-early-findings-from-a-quality-improvement-project/">
2177							<img loading="lazy" width="2560" height="1440" src="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-scaled.jpg" class="attachment-full size-full wp-image-25029" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-scaled.jpg 2560w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-300x169.jpg 300w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-1024x576.jpg 1024w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-768x432.jpg 768w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-1536x864.jpg 1536w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-2048x1152.jpg 2048w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-artempodrez-6823515-600x338.jpg 600w" sizes="(max-width: 2560px) 100v
2177w, 2560px" />								</a>
2178															</div>
2179				</div>
2180				<div class="elementor-element elementor-element-ccccf91 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="ccccf91" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-title.default">
2181				<div class="elementor-widget-container">
2182					<h2 class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/targeted-postoperative-wound-care-kits-delivered-as-part-of-digital-surgical-site-infection-surveillance-after-cardiac-surgery-early-findings-from-a-quality-improvement-project/">Targeted postoperative wound care kits delivered as part of digital surgical site infection surveillance after cardiac surgery: Early findings from a quality improvement project</a></h2>				</div>
2183				</div>
2184					</div>
2185		</div>
2186					</div>
2187		</section>
2188				<section data-dce-background-color="#1E2A54" class="elementor-section elementor-inner-section elementor-element elementor-element-9f0d636 elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="9f0d636" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2189						<div class="elementor-container elementor-column-gap-default">
2190					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-124b6fb" data-id="124b6fb" data-element_type="column" data-e-type="column" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2191			<div class="elementor-widget-wrap elementor-element-populated">
2192						<div data-dce-title-color="#FFFFFF" class="elementor-element elementor-element-2d01e43 elementor-widget elementor-widget-heading" data-id="2d01e43" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default">
2193				<div class="elementor-widget-container">
2194					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/targeted-postoperative-wound-care-kits-delivered-as-part-of-digital-surgical-site-infection-surveillance-after-cardiac-surgery-early-findings-from-a-quality-improvement-project/">18 September 2026</a></p>				</div>
2195				</div>
2196					</div>
2197		</div>
2198					</div>
2199		</section>
2200					</div>
2201		</div>
2202					</div>
2203		</section>
2204				</div>
2205				</article>
2206				<article id="post-25020" class="elementor-post elementor-grid-item ecs-post-loop post-25020 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-arterial-duplex-scanning tag-arterial-ulceration tag-diagnosis tag-leg-ulceration tag-practice-development journal_issue-vol-22-issue-03">
2207				<div data-elementor-type="loop" data-elementor-id="227" class="elementor elementor-227 elementor-location-single post-25020 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-arterial-duplex-scanning tag-arterial-ulceration tag-diagnosis tag-leg-ulceration tag-practice-development journal_issue-vol-22-issue-03" data-elementor-post-type="elementor_library">
2208					<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-top-section elementor-element elementor-element-0115ef3 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="0115ef3" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2209						<div class="elementor-container elementor-column-gap-default">
2210					<div data-dce-background-color="#FFFFFF" class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0bfc1f1" data-id="0bfc1f1" data-element_type="column" data-e-type="column" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2211			<div class="elementor-widget-wrap elementor-element-populated">
2212						<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-inner-section elementor-element elementor-element-bd2ecbc elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="bd2ecbc" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
2213						<div class="elementor-container elementor-column-gap-default">
2214					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-eaefff7" data-id="eaefff7" data-element_type="column" data-e-type="column">
2215			<div class="elementor-widget-wrap elementor-element-populated">
2216						<div class="elementor-element elementor-element-aa93fc7 elementor-widget elementor-widget-theme-post-featured-image elementor-widget-image" data-id="aa93fc7" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-featured-image.default">
2217				<div class="elementor-widget-container">
2218																<a href="https://wounds-uk.com/journal-articles/understanding-arterial-duplex-scanning-in-lower-limb-ulcer-care-a-practical-guide-for-community-nurses-and-tissue-viability-teams/">
2219							<img loading="lazy" width="597" height="392" src="https://wounds-uk.com/wp-content/uploads/2026/09/Picture2.png" class="attachment-full size-full wp-image-25023" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2026/09/Picture2.png 597w, https://wounds-uk.com/wp-content/uploads/2026/09/Picture2-300x197.png 300w" sizes="(max-width: 597px) 100v
2219w, 597px" />								</a>
2220															</div>
2221				</div>
2222				<div class="elementor-element elementor-element-ccccf91 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="ccccf91" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-title.default">
2223				<div class="elementor-widget-container">
2224					<h2 class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/understanding-arterial-duplex-scanning-in-lower-limb-ulcer-care-a-practical-guide-for-community-nurses-and-tissue-viability-teams/">Understanding arterial duplex scanning in lower-limb ulcer care: A practical guide for community nurses and tissue viability teams</a></h2>				</div>
2225				</div>
2226				<div class="elementor-element elementor-element-97e7cc4 elementor-widget elementor-widget-heading" data-id="97e7cc4" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default">
2227				<div class="elementor-widget-container">
2228					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/understanding-arterial-duplex-scanning-in-lower-limb-ulcer-care-a-practical-guide-for-community-nurses-and-tissue-viability-teams/">A practical guide to interpreting arterial duplex ultrasound reports to support safe compression therapy and improve lower limb ulcer care.</a></p>				</div>
2229				</div>
2230					</div>
2231		</div>
2232					</div>
2233		</section>
2234				<section data-dce-background-color="#1E2A54" class="elementor-section elementor-inner-section elementor-element elementor-element-9f0d636 elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="9f0d636" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
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2239				<div class="elementor-widget-container">
2240					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/understanding-arterial-duplex-scanning-in-lower-limb-ulcer-care-a-practical-guide-for-community-nurses-and-tissue-viability-teams/">18 September 2026</a></p>				</div>
2241				</div>
2242					</div>
2243		</div>
2244					</div>
2245		</section>
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2248					</div>
2249		</section>
2250				</div>
2251				</article>
2252				<article id="post-25012" class="elementor-post elementor-grid-item ecs-post-loop post-25012 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-antimicrobial-s tag-editors-pick tag-flaminal tag-infection tag-multimodal-intervention journal_issue-vol-22-issue-03">
2253				<div data-elementor-type="loop" data-elementor-id="227" class="elementor elementor-227 elementor-location-single post-25012 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-antimicrobial-s tag-editors-pick tag-flaminal tag-infection tag-multimodal-intervention journal_issue-vol-22-issue-03" data-elementor-post-type="elementor_library">
2254					<section data-dce-background-color="#FFFFFF" class="elementor-section elementor-top-section elementor-element elementor-element-0115ef3 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="0115ef3" data-element_type="section" data-e-type="section" data-settings="{&quot;background_background&quot;:&quot;classic&quot;}">
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2264																<a href="https://wounds-uk.com/journal-articles/multimodal-wound-care-in-infection-continuum-management-supporting-antimicrobial-stewardship-through-early-intervention/">
2265							<img loading="lazy" width="2560" height="1707" src="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-scaled.jpg" class="attachment-full size-full wp-image-25016" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-scaled.jpg 2560w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-300x200.jpg 300w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-1024x683.jpg 1024w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-768x512.jpg 768w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-1536x1024.jpg 1536w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-2048x1365.jpg 2048w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-laura-james-6097766-600x400.jpg 600w" sizes="(max-width: 2560px) 100v
2265w, 2560px" />								</a>
2266															</div>
2267				</div>
2268				<div class="elementor-element elementor-element-ccccf91 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="ccccf91" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-title.default">
2269				<div class="elementor-widget-container">
2270					<h2 class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/multimodal-wound-care-in-infection-continuum-management-supporting-antimicrobial-stewardship-through-early-intervention/">Multimodal wound care in infection continuum management: Supporting antimicrobial stewardship through early intervention</a></h2>				</div>
2271				</div>
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2274					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/multimodal-wound-care-in-infection-continuum-management-supporting-antimicrobial-stewardship-through-early-intervention/">Early use of Flaminal® in stalled or infected wounds improved healing, reduced pain and infection signs, while lowering costs and freeing clinical time.</a></p>				</div>
2275				</div>
2276					</div>
2277		</div>
2278					</div>
2279		</section>
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2285				<div class="elementor-widget-container">
2286					<p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/journal-articles/multimodal-wound-care-in-infection-continuum-management-supporting-antimicrobial-stewardship-through-early-intervention/">18 September 2026</a></p>				</div>
2287				</div>
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2297				</article>
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2454											<a href="https://wounds-uk.com/log-in/">
2455
2456											<span class="elementor-icon-list-text">My account</span>
2457											</a>
2458									</li>
2459						</ul>
2460						</div>
2461				</div>
2462					</div>
2463		</div>
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2467				<div class="elementor-widget-container">
2468					<p class="elementor-heading-title elementor-size-default">Journals</p>				</div>
2469				</div>
2470				<div class="elementor-element elementor-element-9c5f279 elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="9c5f279" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default">
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2480							<ul class="elementor-icon-list-items">
2481							<li class="elementor-icon-list-item">
2482											<a href="https://www.woundsinternational.com/" target="_blank">
2483
2484											<span class="elementor-icon-list-text">Wounds International</span>
2485											</a>
2486									</li>
2487								<li class="elementor-icon-list-item">
2488											<a href="https://wounds-uk.com">
2489
2490											<span class="elementor-icon-list-text">Wounds UK</span>
2491											</a>
2492									</li>
2493								<li class="elementor-icon-list-item">
2494											<a href="https://wounds-me.com/" target="_blank">
2495
2496											<span class="elementor-icon-list-text">Wounds Middle East</span>
2497											</a>
2498									</li>
2499								<li class="elementor-icon-list-item">
2500											<a href="https://www.woundsasia.com/" target="_blank">
2501
2502											<span class="elementor-icon-list-text">Wounds APAC</span>
2503											</a>
2504									</li>
2505								<li class="elementor-icon-list-item">
2506											<a href="https://diabetesonthenet.com/journals/the-diabetic-foot-journal/" target="_blank">
2507
2508											<span class="elementor-icon-list-text">
2508The Diabetic Foot Journal</span>
2509											</a>
2510									</li>
2511								<li class="elementor-icon-list-item">
2512											<a href="https://www.woundsinternational.com/journals/latest-issue/journal-of-lymphoedema" target="_blank">
2513
2514											<span class="elementor-icon-list-text">Journal of Lymphoedema</span>
2515											</a>
2516									</li>
2517								<li class="elementor-icon-list-item">
2518											<a href="https://wounds-uk.com/wound-essentials/">
2519
2520											<span class="elementor-icon-list-text">Wound Essentials</span>
2521											</a>
2522									</li>
2523						</ul>
2524						</div>
2525				</div>
2526					</div>
2527		</div>
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2531				<div class="elementor-widget-container">
2532					<p class="elementor-heading-title elementor-size-default">Useful information</p>				</div>
2533				</div>
2534				<div class="elementor-element elementor-element-ee7b9f9 elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="ee7b9f9" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default">
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2545							<li class="elementor-icon-list-item">
2546											<a href="https://wounds-uk.com/contact-us/">
2547
2548											<span class="elementor-icon-list-text">Contact us</span>
2549											</a>
2550									</li>
2551								<li class="elementor-icon-list-item">
2552											<a href="https://wounds-uk.com/about-us/">
2553
2554											<span class="elementor-icon-list-text">About us</span>
2555											</a>
2556									</li>
2557								<li class="elementor-icon-list-item">
2558											<a href="https://wounds-uk.com/about-us/editorial-policies-and-ethics-and-malpractice-statement/">
2559
2560											<span class="elementor-icon-list-text">Editorial policies and Ethics and Malpractice statement</span>
2561											</a>
2562									</li>
2563								<li class="elementor-icon-list-item">
2564											<a href="https://wounds-uk.com/about-us/author-guidelines/">
2565
2566											<span class="elementor-icon-list-text">Guide for authors</span>
2567											</a>
2568									</li>
2569								<li class="elementor-icon-list-item">
2570											<a href="https://wounds-uk.com/terms-and-conditions/">
2571
2572											<span class="elementor-icon-list-text">Terms and conditions</span>
2573											</a>
2574									</li>
2575								<li class="elementor-icon-list-item">
2576											<a href="https://wounds-uk.com/privacy-policy/">
2577
2578											<span class="elementor-icon-list-text">Privacy policy</span>
2579											</a>
2580									</li>
2581						</ul>
2582						</div>
2583				</div>
2584					</div>
2585		</div>
2586					</div>
2587		</section>
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2591			<div class="elementor-widget-wrap elementor-element-populated">
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2593				<div class="elementor-widget-container">
2594									<p>© Copyright Omniamed Communications. All Rights Reserved​<br />108 Cannon Street, London, EC4N 6EU. Registered in the United Kingdom​</p>								</div>
2595				</div>
2596					</div>
2597		</div>
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2819					<p class="elementor-heading-title elementor-size-default">Free for all healthcare professionals</p>				</div>
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2849						<div class="elementor-field-subgroup  "><span class="elementor-field-option"><input type="checkbox" value="Wounds International" id="form-field-newsletters_journals-0" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-0">Wounds International</label></span><span class="elementor-field-option"><input type="checkbox" value="Wounds-UK" id="form-field-newsletters_journals-1" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-1">Wounds-UK</label></span><span class="elementor-field-option"><input type="checkbox" value="Wounds Middle East" id="form-field-newsletters_journals-2" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-2">Wounds Middle East</label></span><span class="elementor-field-option"><input type="checkbox" value="Wounds Asia" id="form-field-newsletters_journals-3" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-3">Wounds Asia</label></span><span class="elementor-field-option"><input type="checkbox" value="The Diabetic Foot Journal" id="form-field-newsletters_journals-4" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-4">The Diabetic Foot Journal</label></span><span class="elementor-field-option"><input type="checkbox" value="Journal of Lymphoedema" id="form-field-newsletters_journals-5" name="form_fields[newsletters_journals][]"> <label for="form-field-newsletters_journals-5">Journal of Lymphoedema</label></span></div>				</div>
2850								<div class="elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_4e11155 elementor-col-100">
2851					<br /><br />				</div>
2852								<div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons">
2853					<button class="elementor-button elementor-size-md elementor-animation-shrink" type="submit">
2854						<span class="elementor-button-content-wrapper">
2855																						<span class="elementor-button-text">Subscribe →</span>
2856													</span>
2857					</button>
2858				</div>
2859			</div>
2860		</form>
2861						</div>
2862				</div>
2863				<div class="elementor-element elementor-element-98ab3b8 elementor-widget elementor-widget-text-editor" data-id="98ab3b8" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default">
2864				<div class="elementor-widget-container">
2865									<p>By clicking ‘Subscribe’, you are agreeing that the Wounds Group are able to email you periodic newsletters. You may unsubscribe from these at any time. Your info is safe with us and we will never sell or trade your details. For information please review our 
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2866				</div>
2867					</div>
2868		</div>
2869					</div>
2870		</section>
2871				</section>
2872				<div data-elementor-type="popup" data-elementor-id="187" class="elementor elementor-187 elementor-location-popup" data-elementor-settings="{&quot;entrance_animation&quot;:&quot;zoomIn&quot;,&quot;entrance_animation_tablet&quot;:&quot;none&quot;,&quot;exit_animation&quot;:&quot;zoomIn&quot;,&quot;exit_animation_tablet&quot;:&quot;none&quot;,&quot;prevent_scroll&quot;:&quot;yes&quot;,&quot;entrance_animation_duration&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1.2,&quot;sizes&quot;:[]},&quot;a11y_navigation&quot;:&quot;yes&quot;,&quot;timing&quot;:[]}" data-elementor-post-type="elementor_library">
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2874						<div class="elementor-container elementor-column-gap-default">
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2878				<div class="elementor-widget-container">
2879							<div class="dce-tokens">
2880		<p><iframe style="position: absolute; height: 100vh; border: none;" src=""></iframe></p>		</div>
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2888				<section data-elementor-type="popup" data-elementor-id="98" class="elementor elementor-98 elementor-location-popup" data-elementor-settings="{&quot;entrance_animation_tablet&quot;:&quot;none&quot;,&quot;entrance_animation_mobile&quot;:&quot;none&quot;,&quot;exit_animation_tablet&quot;:&quot;none&quot;,&quot;exit_animation_mobile&quot;:&quot;none&quot;,&quot;entrance_animation&quot;:&quot;none&quot;,&quot;exit_animation&quot;:&quot;none&quot;,&quot;entrance_animation_duration&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:0,&quot;sizes&quot;:[]},&quot;a11y_navigation&quot;:&quot;yes&quot;,&quot;triggers&quot;:[],&quot;timing&quot;:[]}" data-elementor-post-type="elementor_library">
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2890						<div class="elementor-container elementor-column-gap-default">
2891					<div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d8f4002" data-id="d8f4002" data-element_type="column" data-e-type="column">
2892			<div class="elementor-widget-wrap elementor-element-populated">
2893						<div class="elementor-element elementor-element-ba45790 elementor-widget elementor-widget-button" data-id="ba45790" data-element_type="widget" data-e-type="widget" data-settings="{&quot;enabled_visibility&quot;:&quot;yes&quot;,&quot;dce_visibility_selected&quot;:&quot;hide&quot;}" data-widget_type="button.default">
2894				<div class="elementor-widget-container">
2895									<div class="elementor-button-wrapper">
2896					<a class="elementor-button elementor-button-link elementor-size-sm" href="#">
2897						<span class="elementor-button-content-wrapper">
2898						<span class="elementor-button-icon">
2899				<i aria-hidden="true" class="far fa-user-circle"></i>			</span>
2900									<span class="elementor-button-text">Log in | Register</span>
2901					</span>
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2904								</div>
2905				</div>
2906		<!-- dce invisible element f06bd3b -->		<div data-dce-background-color="#FFFFFF" class="elementor-element elementor-element-856c03f elementor-align-right elementor-tablet-align-left elementor-mobile-align-left elementor-widget__width-auto elementor-widget-tablet__width-inherit elementor-widget-mobile__width-inherit elementor-widget elementor-widget-dce-add-to-favorites" data-id="856c03f" data-element_type="widget" data-e-type="widget" data-widget_type="dce-add-to-favorites.default">
2907				<div class="elementor-widget-container">
2908							<div class="elementor-button-wrapper">
2909			<button class="dce-add-to-favorites-add elementor-button elementor-size-md" data-dce-is-favorited="0" data-dce-post-id="25036" data-dce-key="wg_readinglist" data-dce-scope="user" data-dce-whitelist-token="bf043de470913aa52a96fe3afd57fff135093b37ba33240de6013cf33de757eb" data-dce-can-remove-favorites="1" data-dce-login-url="https://wounds-uk.com/wp-login.php" data-dce-action-settings="{&quot;add&quot;:{&quot;title&quot;:&quot;+ Add to reading list&quot;,&quot;icon_html&quot;:&quot;&quot;},&quot;remove&quot;:{&quot;title&quot;:&quot;- Remove from list&quot;,&quot;icon_html&quot;:&quot;&quot;}}" rel="nofollow" data-dce-trigger-finish="1">
2910				<span class="elementor-button-content-wrapper">
2911						
2912					<span class="elementor-button-icon elementor-align-icon-left">
2913											</span>
2914	
2915					<span class="elementor-button-text">+ Add to reading list</span>
2916				</span>
2917			</button>
2918		</div>
2919						</div>
2920				</div>
2921				<div class="elementor-element elementor-element-dcdc837 elementor-widget elementor-widget-button" data-id="dcdc837" data-element_type="widget" data-e-type="widget" data-settings="{&quot;enabled_visibility&quot;:&quot;yes&quot;,&quot;dce_visibility_selected&quot;:&quot;hide&quot;}" data-widget_type="button.default">
2922				<div class="elementor-widget-container">
2923									<div class="elementor-button-wrapper">
2924					<a class="elementor-button elementor-button-link elementor-size-sm" href="https://wounds-uk.com/wp-content/uploads/2026/09/WUK_22-3_16-23_Flen-MASD.pdf">
2925						<span class="elementor-button-content-wrapper">
2926									<span class="elementor-button-text">↓ Download pdf</span>
2927					</span>
2928					</a>
2929				</div>
2930								</div>
2931				</div>
2932		<!-- dce invisible element 6cebd5e -->		<div class="elementor-element elementor-element-11131f9 elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="11131f9" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default">
2933				<div class="elementor-widget-container">
2934							<div class="elementor-divider">
2935			<span class="elementor-divider-separator">
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2939				</div>
2940				<section class="elementor-section elementor-inner-section elementor-element elementor-element-7965954 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="7965954" data-element_type="section" data-e-type="section">
2941						<div class="elementor-container elementor-column-gap-default">
2942					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-ef2c2b2" data-id="ef2c2b2" data-element_type="column" data-e-type="column">
2943			<div class="elementor-widget-wrap elementor-element-populated">
2944						<div class="elementor-element elementor-element-a5fe715 elementor-widget elementor-widget-text-editor" data-id="a5fe715" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default">
2945				<div class="elementor-widget-container">
2946									Share this article								</div>
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2948				<div class="elementor-element elementor-element-ee3310c elementor-share-buttons--view-icon elementor-share-buttons--skin-flat elementor-share-buttons--shape-circle elementor-grid-0 elementor-share-buttons--color-official elementor-widget elementor-widget-share-buttons" data-id="ee3310c" data-element_type="widget" data-e-type="widget" data-widget_type="share-buttons.default">
2949				<div class="elementor-widget-container">
2950							<div class="elementor-grid" role="list">
2951								<div class="elementor-grid-item" role="listitem">
2952						<div class="elementor-share-btn elementor-share-btn_facebook" role="button" tabindex="0" aria-label="Share on facebook">
2953															<span class="elementor-share-btn__icon">
2954								<i class="fab fa-facebook" aria-hidden="true"></i>							</span>
2955																				</div>
2956					</div>
2957									<div class="elementor-grid-item" role="listitem">
2958						<div class="elementor-share-btn elementor-share-btn_twitter" role="button" tabindex="0" aria-label="Share on twitter">
2959															<span class="elementor-share-btn__icon">
2960								<i class="fab fa-twitter" aria-hidden="true"></i>							</span>
2961																				</div>
2962					</div>
2963									<div class="elementor-grid-item" role="listitem">
2964						<div class="elementor-share-btn elementor-share-btn_linkedin" role="button" tabindex="0" aria-label="Share on linkedin">
2965															<span class="elementor-share-btn__icon">
2966								<i class="fab fa-linkedin" aria-hidden="true"></i>							</span>
2967																				</div>
2968					</div>
2969									<div class="elementor-grid-item" role="listitem">
2970						<div class="elementor-share-btn elementor-share-btn_email" role="button" tabindex="0" aria-label="Share on email">
2971															<span class="elementor-share-btn__icon">
2972								<i class="fas fa-envelope" aria-hidden="true"></i>							</span>
2973																				</div>
2974					</div>
2975									<div class="elementor-grid-item" role="listitem">
2976						<div class="elementor-share-btn elementor-share-btn_whatsapp" role="button" tabindex="0" aria-label="Share on whatsapp">
2977															<span class="elementor-share-btn__icon">
2978								<i class="fab fa-whatsapp" aria-hidden="true"></i>							</span>
2979																				</div>
2980					</div>
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2983				</div>
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2985		</div>
2986					</div>
2987		</section>
2988					</div>
2989		</div>
2990					</div>
2991		</section>
2992				</section>
2993				<div data-elementor-type="popup" data-elementor-id="666" class="elementor elementor-666 elementor-location-popup" data-elementor-settings="{&quot;a11y_navigation&quot;:&quot;yes&quot;,&quot;triggers&quot;:{&quot;page_load&quot;:&quot;yes&quot;,&quot;page_load_delay&quot;:0},&quot;timing&quot;:{&quot;times_times&quot;:1,&quot;times&quot;:&quot;yes&quot;,&quot;logged_in&quot;:&quot;yes&quot;,&quot;logged_in_users&quot;:&quot;all&quot;}}" data-elementor-post-type="elementor_library">
2994					<section class="elementor-section elementor-top-section elementor-element elementor-element-3c4dfb7 elementor-section-height-full elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-items-middle" data-id="3c4dfb7" data-element_type="section" data-e-type="section">
2995						<div class="elementor-container elementor-column-gap-default">
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2997			<div class="elementor-widget-wrap elementor-element-populated">
2998						<section class="elementor-section elementor-inner-section elementor-element elementor-element-6bf52a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="6bf52a8" data-element_type="section" data-e-type="section">
2999						<div class="elementor-container elementor-column-gap-default">
3000					<div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-ad1d3a8" data-id="ad1d3a8" data-element_type="column" data-e-type="column">
3001			<div class="elementor-widget-wrap elementor-element-populated">
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3003				<div class="elementor-widget-container">
3004															<img fetchpriority="high" width="800" height="237" src="https://wounds-uk.com/wp-content/uploads/2022/07/Wounds_UK_B.png" class="attachment-large size-large wp-image-3373" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2022/07/Wounds_UK_B.png 930w, https://wounds-uk.com/wp-content/uploads/2022/07/Wounds_UK_B-600x178.png 600w, https://wounds-uk.com/wp-content/uploads/2022/07/Wounds_UK_B-300x89.png 300w, https://wounds-uk.com/wp-content/uploads/2022/07/Wounds_UK_B-768x228.png 768w" sizes="(max-width: 800px) 100vw, 800px" />															</div>
3005				</div>
3006				<div class="elementor-element elementor-element-ddaab3f elementor-widget elementor-widget-text-editor" data-id="ddaab3f" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default">
3007				<div class="elementor-widget-container">
3008									<p><b>Are you a healthcare professional?</b> This website is for healthcare professionals only. To continue, please confirm that you are a healthcare professional below.</p>								</div>
3009				</div>
3010				<div class="elementor-element elementor-element-3d58ee2 elementor-widget elementor-widget-text-editor" data-id="3d58ee2" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default">
3011				<div class="elementor-widget-container">
3012									<p><strong>We use cookies</strong> responsibly to ensure that we give you the best experience on our website. If you continue without changing your browser settings, we&#8217;ll assume that you are happy to receive all cookies on this website. <a href="http://woundsuk.kinsta.cloud/privacy-policy" target="_blank" rel="noopener">Read about how we use cookies</a>.</p>								</div>
3013				</div>
3014					</div>
3015		</div>
3016					</div>
3017		</section>
3018				<section class="elementor-section elementor-inner-section elementor-element elementor-element-50ab229 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="50ab229" data-element_type="section" data-e-type="section">
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3023				<div class="elementor-widget-container">
3024							<a class="elementor-cta" href="#elementor-action%3Aaction%3Dpopup%3Aclose%26settings%3DeyJkb19ub3Rfc2hvd19hZ2FpbiI6InllcyJ9">
3025							<div class="elementor-cta__content">
3026				
3027				
3028									<div class="elementor-cta__description elementor-cta__content-item elementor-content-item">
3029						Yes, I am a healthcare professional.
3030					</div>
3031				
3032									<div class="elementor-cta__button-wrapper elementor-cta__content-item elementor-content-item ">
3033					<span class="elementor-cta__button elementor-button elementor-size-md">
3034						    ✓    					</span>
3035					</div>
3036							</div>
3037						</a>
3038						</div>
3039				</div>
3040					</div>
3041		</div>
3042				<div class="elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-729d8ed" data-id="729d8ed" data-element_type="column" data-e-type="column">
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3044						<div class="elementor-element elementor-element-9aaae92 elementor-cta--valign-top elementor-cta--skin-classic elementor-animated-content elementor-widget elementor-widget-call-to-action" data-id="9aaae92" data-element_type="widget" data-e-type="widget" data-widget_type="call-to-action.default">
3045				<div class="elementor-widget-container">
3046							<div class="elementor-cta">
3047							<div class="elementor-cta__content">
3048				
3049				
3050									<div class="elementor-cta__description elementor-cta__content-item elementor-content-item">
3051						I am <u>not</u> a healthcare professional.					</div>
3052				
3053									<div class="elementor-cta__button-wrapper elementor-cta__content-item elementor-content-item ">
3054					<a class="elementor-cta__button elementor-button elementor-size-md" href="https://omniamedcommunications.com/">
3055						    ✘    					</a>
3056					</div>
3057							</div>
3058						</div>
3059						</div>
3060				</div>
3061					</div>
3062		</div>
3063					</div>
3064		</section>
3065					</div>
3066		</div>
3067					</div>
3068		</section>
3069				</div>
3070					
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3104
3105	<style id="wp-block-paragraph-inline-css">
3106/**
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3108 *
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3112 */
3113/**
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3116/**
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3119/**
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3122/**
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3312<script id="ecs-scheme-selector-js" src="https://wounds-uk.com/wp-content/plugins/ele-custom-skin-pro/assets/js/ecs-scheme-selector.js?ver=4.2.2"></script>
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3312
3313<script id="smartmenus-js" src="https://wounds-uk.com/wp-content/plugins/elementor-pro/assets/lib/smartmenus/jquery.smartmenus.js?ver=1.2.1"></script>
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3313
3314<script id="e-sticky-js" src="https://wounds-uk.com/wp-content/plugins/elementor-pro/assets/lib/sticky/jquery.sticky.js?ver=4.2.3"></script>
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3314
3315<script id="underscore-js" src="https://wounds-uk.com/wp-includes/js/underscore.min.js?ver=1.13.8"></script>
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3315
3316<script id="wp-util-js-extra">
3317var _wpUtilSettings = {"ajax":{"url":"/wp-admin/admin-ajax.php"}};
3318//# sourceURL=wp-util-js-extra
3319</script>
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3319
3320<script id="wp-util-js" src="https://wounds-uk.com/wp-includes/js/wp-util.js?ver=7.1.2"></script>
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3320
3321<script id="dce-fix-background-loop-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/js/fix-background-loop.js?ver=3.4.14"></script>
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3321
3322<script id="dce-settings-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/js/settings.js?ver=3.4.14"></script>
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3322
3323<script id="dce-add-to-favorites-js-extra">
3324var dce_vars = {"ajaxurl":"https://wounds-uk.com/wp-admin/admin-ajax.php","nonce":"b1245b9e01"};
3325//# sourceURL=dce-add-to-favorites-js-extra
3326</script>
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3326
3327<script id="dce-add-to-favorites-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/js/add-to-favorites.js?ver=3.4.14"></script>
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3327
3328<script id="dce-accordionjs-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/node/accordionjs/accordion.min.js?ver=3.4.14"></script>
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3328
3329<script id="imagesloaded-js" src="https://wounds-uk.com/wp-includes/js/imagesloaded.min.js?ver=5.0.0"></script>
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3329
3330<script id="masonry-js" src="https://wounds-uk.com/wp-includes/js/masonry.min.js?ver=4.2.2"></script>
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3330
3331<script id="jquery-masonry-js" src="https://wounds-uk.com/wp-includes/js/jquery/jquery.masonry.min.js?ver=3.1.2b"></script>
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3331
3332<script id="dce-wow-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/node/wowjs/wow.min.js?ver=3.4.14"></script>
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3332
3333<script id="dce-datatables-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/node/datatables/datatables.min.js?ver=3.4.14"></script>
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3333
3334<script id="dce-acf-repeater-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/js/acf-repeater.js?ver=3.4.14"></script>
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3334
3335<script id="sourcebuster-js-js" src="https://wounds-uk.com/wp-content/plugins/woocommerce/assets/js/sourcebuster/sourcebuster.js?ver=11.1.1"></script>
vendor: 1 bytes, line 3335
3335
3336<script id="wc-order-attribution-js-extra">
3337var wc_order_attribution = {"params":{"lifetime":1.0e-5,"session":30,"base64":false,"ajaxurl":"https://wounds-uk.com/wp-admin/admin-ajax.php","prefix":"wc_order_attribution_","allowTracking":true},"fields":{"source_type":"current.typ","referrer":"current_add.rf","utm_campaign":"current.cmp","utm_source":"current.src","utm_medium":"current.mdm","utm_content":"current.cnt","utm_id":"current.id","utm_term":"current.trm","utm_source_platform":"current.plt","utm_creative_format":"current.fmt","utm_marketing_tactic":"current.tct","session_entry":"current_add.ep","session_start_time":"current_add.fd","session_pages":"session.pgs","session_count":"udata.vst","user_agent":"udata.uag"}};
3338//# sourceURL=wc-order-attribution-js-extra
3339</script>
vendor: 1 bytes, line 3339
3339
3340<script id="wc-order-attribution-js" src="https://wounds-uk.com/wp-content/plugins/woocommerce/assets/js/frontend/order-attribution.js?ver=11.1.1"></script>
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3340
3341<script id="dce-visibility-js" src="https://wounds-uk.com/wp-content/plugins/dynamic-content-for-elementor/assets/js/visibility.js?ver=3.4.14"></script>
vendor: 1 bytes, line 3341
3341
3342<script id="elementor-pro-webpack-runtime-js" src="https://wounds-uk.com/wp-content/plugins/elementor-pro/assets/js/webpack-pro.runtime.js?ver=4.2.3"></script>
vendor: 1 bytes, line 3342
3342
3343<script id="wp-hooks-js" src="https://wounds-uk.com/wp-includes/js/dist/hooks.js?ver=f0f188028580e8dc1255"></script>
vendor: 1 bytes, line 3343
3343
3344<script id="wp-i18n-js" src="https://wounds-uk.com/wp-includes/js/dist/i18n.js?ver=1dfe7db3940c23ea9216"></script>
vendor: 1 bytes, line 3344
3344
3345<script id="wp-i18n-js-after">
3346wp.i18n.setLocaleData( { 'text direction\u0004ltr': [ 'ltr' ] } );
3347//# sourceURL=wp-i18n-js-after
3348</script>
vendor: 1 bytes, line 3348
3348
3349<script id="elementor-pro-frontend-js-before">
3350var ElementorProFrontendConfig = {"ajaxurl":"https:\/\/wounds-uk.com\/wp-admin\/admin-ajax.php","nonce":"c0d5525924","urls":{"assets":"https:\/\/wounds-uk.com\/wp-content\/plugins\/elementor-pro\/assets\/","rest":"https:\/\/wounds-uk.com\/wp-json\/"},"settings":{"lazy_load_background_images":true},"popup":{"hasPopUps":true},"shareButtonsNetworks":{"facebook":{"title":"Facebook","has_counter":true},"twitter":{"title":"Twitter"},"linkedin":{"title":"LinkedIn","has_counter":true},"pinterest":{"title":"Pinterest","has_counter":true},"reddit":{"title":"Reddit","has_counter":true},"vk":{"title":"VK","has_counter":true},"odnoklassniki":{"title":"OK","has_counter":true},"tumblr":{"title":"Tumblr"},"digg":{"title":"Digg"},"skype":{"title":"Skype"},"stumbleupon":{"title":"StumbleUpon","has_counter":true},"mix":{"title":"Mix"},"telegram":{"title":"Telegram"},"pocket":{"title":"Pocket","has_counter":true},"xing":{"title":"XING","has_counter":true},"whatsapp":{"title":"WhatsApp"},"email":{"title":"Email"},"print":{"title":"Print"},"x-twitter":{"title":"X"},"threads":{"title":"Threads"}},"woocommerce":{"menu_cart":{"cart_page_url":"https:\/\/wounds-uk.com\/basket\/","checkout_page_url":"https:\/\/wounds-uk.com\/checkout\/","fragments_nonce":"8bcc2904be"}},"facebook_sdk":{"lang":"en_GB","app_id":""},"lottie":{"defaultAnimationUrl":"https:\/\/wounds-uk.com\/wp-content\/plugins\/elementor-pro\/modules\/lottie\/assets\/animations\/default.json"}};
3351//# sourceURL=elementor-pro-frontend-js-before
3352</script>
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3352
3353<script id="elementor-pro-frontend-js" src="https://wounds-uk.com/wp-content/plugins/elementor-pro/assets/js/frontend.js?ver=4.2.3"></script>
vendor: 1 bytes, line 3353
3353
3354<script id="pro-elements-handlers-js" src="https://wounds-uk.com/wp-content/plugins/elementor-pro/assets/js/elements-handlers.js?ver=4.2.3"></script>
vendor: 1 bytes, line 3354
3354
3355<script id="ecspro-js" src="https://wounds-uk.com/wp-content/plugins/ele-custom-skin-pro/assets/js/ecspro.js?ver=4.2.2"></script>
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3355
3356<script id="wp-emoji-settings" type="application/json">
3357{"baseUrl":"https://s.w.org/images/core/emoji/17.0.2/72x72/","ext":".png","svgUrl":"https://s.w.org/images/core/emoji/17.0.2/svg/","svgExt":".svg","source":{"wpemoji":"https://wounds-uk.com/wp-includes/js/wp-emoji.js?ver=7.1.2","twemoji":"https://wounds-uk.com/wp-includes/js/twemoji.js?ver=7.1.2"}}
3358</script>
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3358
3359<script type="module">
3360/**
3361 * @output wp-includes/js/wp-emoji-loader.js
3362 */
3363
3364/* eslint-env es6 */
3365
3366// Note: This is loaded as a script module, so there is no need for an IIFE to prevent pollution of the global scope.
3367
3368/**
3369 * Emoji Settings as exported in PHP via _print_emoji_detection_script().
3370 * @typedef WPEmojiSettings
3371 * @type {object}
3372 * @property {?object} source
3373 * @property {?string} source.concatemoji
3374 * @property {?string} source.twemoji
3375 * @property {?string} source.wpemoji
3376 */
3377
3378const selector = 'script#wp-emoji-settings';
3379const script = document.querySelector( selector );
3380if ( ! ( script instanceof HTMLScriptElement ) ) {
3381	throw new Error( `Element missing: ${ selector }`);
3382}
3383const settings = /** @type {WPEmojiSettings} */ ( JSON.parse( script.text ) );
3384
3385// For compatibility with other scripts that read from this global, in particular wp-includes/js/wp-emoji.js (source file: js/_enqueues/wp/emoji.js).
3386window._wpemojiSettings = settings;
3387
3388/**
3389 * Support tests.
3390 * @typedef SupportTests
3391 * @type {object}
3392 * @property {?boolean} flag
3393 * @property {?boolean} emoji
3394 */
3395
3396const sessionStorageKey = 'wpEmojiSettingsSupports';
3397const tests = [ 'flag', 'emoji' ];
3398
3399/**
3400 * Checks whether the browser supports offloading to a Worker.
3401 *
3402 * @since 6.3.0
3403 *
3404 * @private
3405 *
3406 * @returns {boolean}
3407 */
3408function supportsWorkerOffloading() {
3409	return (
3410		typeof Worker !== 'undefined' &&
3411		typeof OffscreenCanvas !== 'undefined' &&
3412		typeof URL !== 'undefined' &&
3413		URL.createObjectURL &&
3414		typeof Blob !== 'undefined'
3415	);
3416}
3417
3418/**
3419 * @typedef SessionSupportTests
3420 * @type {object}
3421 * @property {number} timestamp
3422 * @property {SupportTests} supportTests
3423 */
3424
3425/**
3426 * Get support tests from session.
3427 *
3428 * @since 6.3.0
3429 *
3430 * @private
3431 *
3432 * @returns {?SupportTests} Support tests, or null if not set or older than 1 week.
3433 */
3434function getSessionSupportTests() {
3435	try {
3436		/** @type {SessionSupportTests} */
3437		const item = JSON.parse(
3438			sessionStorage.getItem( sessionStorageKey )
3439		);
3440		if (
3441			typeof item === 'object' &&
3442			typeof item.timestamp === 'number' &&
3443			new Date().valueOf() < item.timestamp + 604800 && // Note: Number is a week in seconds.
3444			typeof item.supportTests === 'object'
3445		) {
3446			return item.supportTests;
3447		}
3448	} catch ( e ) {}
3449	return null;
3450}
3451
3452/**
3453 * Persist the supports in session storage.
3454 *
3455 * @since 6.3.0
3456 *
3457 * @private
3458 *
3459 * @param {SupportTests} supportTests Support tests.
3460 */
3461function setSessionSupportTests( supportTests ) {
3462	try {
3463		/** @type {SessionSupportTests} */
3464		const item = {
3465			supportTests: supportTests,
3466			timestamp: new Date().valueOf()
3467		};
3468
3469		sessionStorage.setItem(
3470			sessionStorageKey,
3471			JSON.stringify( item )
3472		);
3473	} catch ( e ) {}
3474}
3475
3476/**
3477 * Checks if two sets of Emoji characters render the same visually.
3478 *
3479 * This is used to determine if the browser is rendering an emoji with multiple data points
3480 * correctly. set1 is the emoji in the correct form, using a zero-width joiner. set2 is the emoji
3481 * in the incorrect form, using a zero-width space. If the two sets render the same, then the browser
3482 * does not support the emoji correctly.
3483 *
3484 * This function may be serialized to run in a Worker. Therefore, it cannot refer to variables from the containing
3485 * scope. Everything must be passed by parameters.
3486 *
3487 * @since 4.9.0
3488 *
3489 * @private
3490 *
3491 * @param {CanvasRenderingContext2D} context 2D Context.
3492 * @param {string} set1 Set of Emoji to test.
3493 * @param {string} set2 Set of Emoji to test.
3494 *
3495 * @return {boolean} True if the two sets render the same.
3496 */
3497function emojiSetsRenderIdentically( context, set1, set2 ) {
3498	// Cleanup from previous test.
3499	context.clearRect( 0, 0, context.canvas.width, context.canvas.height );
3500	context.fillText( set1, 0, 0 );
3501	const rendered1 = new Uint32Array(
3502		context.getImageData(
3503			0,
3504			0,
3505			context.canvas.width,
3506			context.canvas.height
3507		).data
3508	);
3509
3510	// Cleanup from previous test.
3511	context.clearRect( 0, 0, context.canvas.width, context.canvas.height );
3512	context.fillText( set2, 0, 0 );
3513	const rendered2 = new Uint32Array(
3514		context.getImageData(
3515			0,
3516			0,
3517			context.canvas.width,
3518			context.canvas.height
3519		).data
3520	);
3521
3522	return rendered1.every( ( rendered2Data, index ) => {
3523		return rendered2Data === rendered2[ index ];
3524	} );
3525}
3526
3527/**
3528 * Checks if the center point of a single emoji is empty.
3529 *
3530 * This is used to determine if the browser is rendering an emoji with a single data point
3531 * correctly. The center point of an incorrectly rendered emoji will be empty. A correctly
3532 * rendered emoji will have a non-zero value at the center point.
3533 *
3534 * This function may be serialized to run in a Worker. Therefore, it cannot refer to variables from the containing
3535 * scope. Everything must be passed by parameters.
3536 *
3537 * @since 6.8.2
3538 *
3539 * @private
3540 *
3541 * @param {CanvasRenderingContext2D} context 2D Context.
3542 * @param {string} emoji Emoji to test.
3543 *
3544 * @return {boolean} True if the center point is empty.
3545 */
3546function emojiRendersEmptyCenterPoint( context, emoji ) {
3547	// Cleanup from previous test.
3548	context.clearRect( 0, 0, context.canvas.width, context.canvas.height );
3549	context.fillText( emoji, 0, 0 );
3550
3551	// Test if the center point (16, 16) is empty (0,0,0,0).
3552	const centerPoint = context.getImageData(16, 16, 1, 1);
3553	for ( let i = 0; i < centerPoint.data.length; i++ ) {
3554		if ( centerPoint.data[ i ] !== 0 ) {
3555			// Stop checking the moment it's known not to be empty.
3556			return false;
3557		}
3558	}
3559
3560	return true;
3561}
3562
3563/**
3564 * Determines if the browser properly renders Emoji that Twemoji can supplement.
3565 *
3566 * This function may be serialized to run in a Worker. Therefore, it cannot refer to variables from the containing
3567 * scope. Everything must be passed by parameters.
3568 *
3569 * @since 4.2.0
3570 *
3571 * @private
3572 *
3573 * @param {CanvasRenderingContext2D} context 2D Context.
3574 * @param {string} type Whether to test for support of "flag" or "emoji".
3575 * @param {Function} emojiSetsRenderIdentically Reference to emojiSetsRenderIdentically function, needed due to minification.
3576 * @param {Function} emojiRendersEmptyCenterPoint Reference to emojiRendersEmptyCenterPoint function, needed due to minification.
3577 *
3578 * @return {boolean} True if the browser can render emoji, false if it cannot.
3579 */
3580function browserSupportsEmoji( context, type, emojiSetsRenderIdentically, emojiRendersEmptyCenterPoint ) {
3581	let isIdentical;
3582
3583	switch ( type ) {
3584		case 'flag':
3585			/*
3586			 * Test for Transgender flag compatibility. Added in Unicode 13.
3587			 *
3588			 * To test for support, we try to render it, and compare the rendering to how it would look if
3589			 * the browser doesn't render it correctly (white flag emoji + transgender symbol).
3590			 */
3591			isIdentical = emojiSetsRenderIdentically(
3592				context,
3593				'\uD83C\uDFF3\uFE0F\u200D\u26A7\uFE0F', // as a zero-width joiner sequence
3594				'\uD83C\uDFF3\uFE0F\u200B\u26A7\uFE0F' // separated by a zero-width space
3595			);
3596
3597			if ( isIdentical ) {
3598				return false;
3599			}
3600
3601			/*
3602			 * Test for Sark flag compatibility. This is the least supported of the letter locale flags,
3603			 * so gives us an easy test for full support.
3604			 *
3605			 * To test for support, we try to render it, and compare the rendering to how it would look if
3606			 * the browser doesn't render it correctly ([C] + [Q]).
3607			 */
3608			isIdentical = emojiSetsRenderIdentically(
3609				context,
3610				'\uD83C\uDDE8\uD83C\uDDF6', // as the sequence of two code points
3611				'\uD83C\uDDE8\u200B\uD83C\uDDF6' // as the two code points separated by a zero-width space
3612			);
3613
3614			if ( isIdentical ) {
3615				return false;
3616			}
3617
3618			/*
3619			 * Test for English flag compatibility. England is a country in the United Kingdom, it
3620			 * does not have a two letter locale code but rather a five letter sub-division code.
3621			 *
3622			 * To test for support, we try to render it, and compare the rendering to how it would look if
3623			 * the browser doesn't render it correctly (black flag emoji + [G] + [B] + [E] + [N] + [G]).
3624			 */
3625			isIdentical = emojiSetsRenderIdentically(
3626				context,
3627				// as the flag sequence
3628				'\uD83C\uDFF4\uDB40\uDC67\uDB40\uDC62\uDB40\uDC65\uDB40\uDC6E\uDB40\uDC67\uDB40\uDC7F',
3629				// with each code point separated by a zero-width space
3630				'\uD83C\uDFF4\u200B\uDB40\uDC67\u200B\uDB40\uDC62\u200B\uDB40\uDC65\u200B\uDB40\uDC6E\u200B\uDB40\uDC67\u200B\uDB40\uDC7F'
3631			);
3632
3633			return ! isIdentical;
3634		case 'emoji':
3635			/*
3636			 * Is there a large, hairy, humanoid mythical creature living in the browser?
3637			 *
3638			 * To test for Emoji 17.0 support, try to render a new emoji: Hairy Creature.
3639			 *
3640			 * The hairy creature emoji is a single code point emoji. Testing for browser
3641			 * support required testing the center point of the emoji to see if it is empty.
3642			 *
3643			 * 0xD83E 0x1FAC8 (\uD83E\u1FAC8) == 🫈 Hairy creature.
3644			 *
3645			 * When updating this test, please ensure that the emoji is either a single code point
3646			 * or switch to using the emojiSetsRenderIdentically function and testing with a zero-width
3647			 * joiner vs a zero-width space.
3648			 */
3649			const notSupported = emojiRendersEmptyCenterPoint( context, '\uD83E\u1FAC8' );
3650			return ! notSupported;
3651	}
3652
3653	return false;
3654}
3655
3656/**
3657 * Checks emoji support tests.
3658 *
3659 * This function may be serialized to run in a Worker. Therefore, it cannot refer to variables from the containing
3660 * scope. Everything must be passed by parameters.
3661 *
3662 * @since 6.3.0
3663 *
3664 * @private
3665 *
3666 * @param {string[]} tests Tests.
3667 * @param {Function} browserSupportsEmoji Reference to browserSupportsEmoji function, needed due to minification.
3668 * @param {Function} emojiSetsRenderIdentically Reference to emojiSetsRenderIdentically function, needed due to minification.
3669 * @param {Function} emojiRendersEmptyCenterPoint Reference to emojiRendersEmptyCenterPoint function, needed due to minification.
3670 *
3671 * @return {SupportTests} Support tests.
3672 */
3673function testEmojiSupports( tests, browserSupportsEmoji, emojiSetsRenderIdentically, emojiRendersEmptyCenterPoint ) {
3674	let canvas;
3675	if (
3676		typeof WorkerGlobalScope !== 'undefined' &&
3677		self instanceof WorkerGlobalScope
3678	) {
3679		canvas = new OffscreenCanvas( 300, 150 ); // Dimensions are default for HTMLCanvasElement.
3680	} else {
3681		canvas = document.createElement( 'canvas' );
3682	}
3683
3684	const context = canvas.getContext( '2d', { willReadFrequently: true } );
3685
3686	/*
3687	 * Chrome on OS X added native emoji rendering in M41. Unfortunately,
3688	 * it doesn't work when the font is bolder than 500 weight. So, we
3689	 * check for bold rendering support to avoid invisible emoji in Chrome.
3690	 */
3691	context.textBaseline = 'top';
3692	context.font = '600 32px Arial';
3693
3694	const supports = {};
3695	tests.forEach( ( test ) => {
3696		supports[ test ] = browserSupportsEmoji( context, test, emojiSetsRenderIdentically, emojiRendersEmptyCenterPoint );
3697	} );
3698	return supports;
3699}
3700
3701/**
3702 * Adds a script to the head of the document.
3703 *
3704 * @ignore
3705 *
3706 * @since 4.2.0
3707 *
3708 * @param {string} src The url where the script is located.
3709 *
3710 * @return {void}
3711 */
3712function addScript( src ) {
3713	const script = document.createElement( 'script' );
3714	script.src = src;
3715	script.defer = true;
3716	document.head.appendChild( script );
3717}
3718
3719settings.supports = {
3720	everything: true,
3721	everythingExceptFlag: true
3722};
3723
3724// Obtain the emoji support from the browser, asynchronously when possible.
3725new Promise( ( resolve ) => {
3726	let supportTests = getSessionSupportTests();
3727	if ( supportTests ) {
3728		resolve( supportTests );
3729		return;
3730	}
3731
3732	if ( supportsWorkerOffloading() ) {
3733		try {
3734			// Note that the functions are being passed as arguments due to minification.
3735			const workerScript =
3736				'postMessage(' +
3737				testEmojiSupports.toString() +
3738				'(' +
3739				[
3740					JSON.stringify( tests ),
3741					browserSupportsEmoji.toString(),
3742					emojiSetsRenderIdentically.toString(),
3743					emojiRendersEmptyCenterPoint.toString()
3744				].join( ',' ) +
3745				'));';
3746			const blob = new Blob( [ workerScript ], {
3747				type: 'text/javascript'
3748			} );
3749			const worker = new Worker( URL.createObjectURL( blob ), { name: 'wpTestEmojiSupports' } );
3750			worker.onmessage = ( event ) => {
3751				supportTests = event.data;
3752				setSessionSupportTests( supportTests );
3753				worker.terminate();
3754				resolve( supportTests );
3755			};
3756			return;
3757		} catch ( e ) {}
3758	}
3759
3760	supportTests = testEmojiSupports( tests, browserSupportsEmoji, emojiSetsRenderIdentically, emojiRendersEmptyCenterPoint );
3761	setSessionSupportTests( supportTests );
3762	resolve( supportTests );
3763} )
3764	// Once the browser emoji support has been obtained from the session, finalize the settings.
3765	.then( ( supportTests ) => {
3766		/*
3767		 * Tests the browser support for flag emojis and other emojis, and adjusts the
3768		 * support settings accordingly.
3769		 */
3770		for ( const test in supportTests ) {
3771			settings.supports[ test ] = supportTests[ test ];
3772
3773			settings.supports.everything =
3774				settings.supports.everything && settings.supports[ test ];
3775
3776			if ( 'flag' !== test ) {
3777				settings.supports.everythingExceptFlag =
3778					settings.supports.everythingExceptFlag &&
3779					settings.supports[ test ];
3780			}
3781		}
3782
3783		settings.supports.everythingExceptFlag =
3784			settings.supports.everythingExceptFlag &&
3785			! settings.supports.flag;
3786
3787		// When the browser can not render everything we need to load a polyfill.
3788		if ( ! settings.supports.everything ) {
3789			const src = settings.source || {};
3790
3791			if ( src.concatemoji ) {
3792				addScript( src.concatemoji );
3793			} else if ( src.wpemoji && src.twemoji ) {
3794				addScript( src.twemoji );
3795				addScript( src.wpemoji );
3796			}
3797		}
3798	} );
3799//# sourceURL=https://wounds-uk.com/wp-includes/js/wp-emoji-loader.js
3800</script>
3800
3801
3802</body>
3803</html>
3804
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