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955<script data-cfasync="false" data-pagespeed-no-defer data-cookieconsent="ignore"> 956 var dataLayer_content = {"visitorLoginState":"logged-out","visitorType":"visitor-logged-out","visitorEmail":"","visitorEmailHash":"","visitorRegistrationDate":"","visitorUsername":"","pageTitle":"Understanding the factors influencing cliniciansâ adoption of Moisture-Associated Skin Damage (MASD) Best Practice Guidance: A qualitative interview study |","pagePostType":"post","pagePostType2":"single-post","pageCategory":["journal-articles"],"pageAttributes":["best-practice","editors-pick","masd","moisture-associated-skin-damage","practice-development","skin-integrity","wound-care"],"pagePostAuthorID":18114,"pagePostAuthor":"Aleksandra Mendykowska","pagePostDate":"18 September 2026","pagePostDateYear":"2026","pagePostDateMonth":"09","pagePostDateDay":"18","pagePostDateDayName":"Friday","pagePostDateHour":"09","pagePostDateMinute":"11","pagePostDateIso":"2026-09-18T09:11:00+01:00","pagePostDateUnix":1789722660,"pagePostTerms":{"category":["Journal Articles"],"post_tag":["Best practice","Editor\u0026#039;s Pick","MASD","Moisture-associated skin damage","Practice development","Skin integrity","Wound care"],"journal_issue":["Vol: 22 | Issue: 03"],"meta":{"content-type":"","footnotes":"","meta_description":"Interviews found barriers to MASD guidance uptake, but showed education, wider dissemination and simple resources can improve care.","page_number":"","citation":"","digital_edition":"","except_abstract_or_content_summary":"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.\r\nAim: To explore cliniciansâ 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. Participants included tissue viability nurses, specialist clinicians and generalist practitioners.\r\nResults: 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. \r\nConclusion: 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.","author_speaker_details_0_author_speaker_name":"Karen Ousey","author_speaker_details_0_author_speaker_job_title":"","author_speaker_details_0_author_speaker_image":"","author_speaker_details_0_author_speaker_bio":"","author_speaker_details":"1","supporting_file":"25037","video_link":"","disclaimer":"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. ","references":"Best Practice Statement (2025) Understanding types of Moisture-Associated skin damage (MASD): prevention, identification and management. London: Wounds UK. Available to download from: \u003Ca href=\u0022http:\/\/www.wounds-uk.com\u0022\u003Ewww.wounds-uk.com\u003C\/a\u003E\r\n\r\nBoltin D, Kimchi N, Dickman R, et al (2016) Attitudes and practice related to Helicobacter pylori infection among primary care physicians. Eur J Gastroenterol Hepatol 28:1035â40.\r\n\r\nBosch 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;13:161â8.\r\n\r\nBraun, V., \u0026amp; Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77â101. \u003Ca href=\u0022https:\/\/doi.org\/10.1191\/1478088706qp063oa\u0022\u003Ehttps:\/\/doi.org\/10.1191\/1478088706qp063oa\u003C\/a\u003E\r\n\r\nChambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8(1):117. \u003Ca href=\u0022https:\/\/doi.org\/10.1186\/1748-5908-8-117\u0022\u003Ehttps:\/\/doi.org\/10.1186\/1748-5908-8-117\u003C\/a\u003E.\r\n\r\nEccles MP, Mittman BS. Welcome to Implementation Science. Implement Sci. 2006;1:1.\r\n\r\nKilsdonk 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;98:56â64\r\n\r\nKredo T, Bernhardsson S, Machingaidze S, et al. Guide to clinical practice guidelines: the current state of play. Int J Qual Health Care 2016;28:122â8.\r\n\r\nMilchak 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):602â8.\r\n\r\nRogers EM. Diffusion of innovations. New York: Free Press; 2003.\r\n\r\nStraus SE, Tetroe J, Graham ID. Knowledge translation in health care: moving from evidence to practice. 2nd ed. Chichester, UK: Wiley-Blackwell\/ BMJ; 2009. p. 1â318.\r\n\r\nvan de Klundert J, Gorissen P, Zeemering S. Measuring clinical pathway adherence. J Biomed Inform. 2010;43(6):861â72.\r\n\r\nWang 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\r\n\r\nWensing, M., Grol, R. Knowledge translation in health: how implementation science could contribute more. 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1132 </div> 1133 </div> 1134 </div> 1135 </div> 1136 </section> 1137 </header> 1138 <div data-elementor-type="single-post" data-elementor-id="53" class="elementor elementor-53 elementor-location-single post-25036 post type-post status-publish format-standard has-post-thumbnail hentry category-journal-articles tag-best-practice tag-editors-pick tag-masd tag-moisture-associated-skin-damage tag-practice-development tag-skin-integrity tag-wound-care journal_issue-vol-22-issue-03" data-elementor-post-type="elementor_library"> 1139 <section data-dce-background-color="#EAEAEA" class="elementor-section elementor-top-section elementor-element elementor-element-a707740 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="a707740" data-element_type="section" data-e-type="section" data-settings="{"background_background":"classic"}"> 1140 <div class="elementor-container elementor-column-gap-default"> 1141 <div class="elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-4844080" data-id="4844080" data-element_type="column" data-e-type="column"> 1142 <div class="elementor-widget-wrap elementor-element-populated"> 1143 <div class="elementor-element elementor-element-24223cd elementor-widget elementor-widget-heading" data-id="24223cd" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default"> 1144 <div class="elementor-widget-container"> 1145 <p class="elementor-heading-title elementor-size-default"><span>Journal Articles</span></p> </div> 1146 </div> 1147 <div class="elementor-element elementor-element-bb1668a elementor-widget elementor-widget-heading" data-id="bb1668a" data-element_type="widget" data-e-type="widget" data-widget_type="heading.default"> 1148 <div class="elementor-widget-container"> 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> 1151 <section class="elementor-section elementor-inner-section elementor-element elementor-element-6caccd3 elementor-hidden-tablet elementor-hidden-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="6caccd3" data-element_type="section" data-e-type="section"> 1152 <div class="elementor-container elementor-column-gap-default"> 1153 <div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-b6f5f6c" data-id="b6f5f6c" data-element_type="column" data-e-type="column"> 1154 <div class="elementor-widget-wrap elementor-element-populated"> 1155 <div class="elementor-element elementor-element-04c9bbb animated-fast elementor-invisible elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="04c9bbb" data-element_type="widget" data-e-type="widget" data-settings="{"motion_fx_motion_fx_scrolling":"yes","motion_fx_opacity_effect":"yes","motion_fx_opacity_range":{"unit":"%","size":"","sizes":{"start":66,"end":70}},"motion_fx_range":"viewport","_animation":"fadeIn","_animation_delay":1,"motion_fx_opacity_direction":"out-in","motion_fx_opacity_level":{"unit":"px","size":10,"sizes":[]},"motion_fx_devices":["desktop","tablet","mobile"]}" data-widget_type="theme-post-title.default"> 1156 <div class="elementor-widget-container"> 1157 <h1 class="elementor-heading-title elementor-size-default">Understanding the factors influencing cliniciansâ adoption of Moisture-Associated Skin Damage (MASD) Best Practice Guidance: A qualitative interview study</h1> </div>
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1223 </div> 1224 <div data-dce-title-color="#686868" class="elementor-element elementor-element-968197c elementor-widget elementor-widget-heading" data-id="968197c" data-element_type="widget" data-e-type="widget" data-settings="{"enabled_visibility":"yes","dce_visibility_selected":"hide"}" data-widget_type="heading.default"> 1225 <div class="elementor-widget-container"> 1226 <p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/wp-content/uploads/2026/09/WUK_22-3_16-23_Flen-MASD.pdf" target="_blank">â Download pdf</a></p> </div> 1227 </div> 1228 </div> 1229 </div> 1230 </div> 1231 </section> 1232 </div> 1233 </div> 1234 <div class="elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-c7be6f4" data-id="c7be6f4" data-element_type="column" data-e-type="column"> 1235 <div class="elementor-widget-wrap elementor-element-populated"> 1236 <section data-dce-background-color="#F4F4F4" class="elementor-section elementor-inner-section elementor-element elementor-element-9da70e4 elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="9da70e4" data-element_type="section" data-e-type="section" data-settings="{"background_background":"classic"}"> 1237 <div class="elementor-container elementor-column-gap-default"> 1238 <div class="elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-7759285" data-id="7759285" data-element_type="column" data-e-type="column"> 1239 <div class="elementor-widget-wrap elementor-element-populated"> 1240 <div data-dce-text-color="#FFFFFF" data-dce-advanced-background-color="#579ED8" class="elementor-element elementor-element-be7160a elementor-widget__width-auto elementor-widget elementor-widget-text-editor" data-id="be7160a" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default"> 1241 <div class="elementor-widget-container"> 1242 <a href="https://wounds-uk.com/subject/best-practice/" rel="tag">Best practice</a>, <a href="https://wounds-uk.com/subject/editors-pick/" rel="tag">Editor's Pick</a>, <a href="https://wounds-uk.com/subject/masd/" rel="tag">MASD</a>, <a href="https://wounds-uk.com/subject/moisture-associated-skin-damage/" rel="tag">Moisture-associated skin damage</a>, <a href="https://wounds-uk.com/subject/practice-development/" rel="tag">Practice development</a>, <a href="https://wounds-uk.com/subject/skin-integrity/" rel="tag">Skin integrity</a>, <a href="https://wounds-uk.com/subject/wound-care/" rel="tag">Wound care</a> </div> 1243 </div> 1244 <div class="elementor-element elementor-element-30c145f elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading" data-id="30c145f" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-title.default"> 1245 <div class="elementor-widget-container"> 1246 <h1 class="elementor-heading-title elementor-size-default">Understanding the factors influencing cliniciansâ adoption of Moisture-Associated Skin Damage (MASD) Best Practice Guidance: A qualitative interview study</h1> </div> 1247 </div> 1248 <div class="dce-fix-background-loop elementor-element elementor-element-997343e elementor-widget elementor-widget-dce-acf-repeater-v2" data-id="997343e" data-element_type="widget" data-e-type="widget" data-widget_type="dce-acf-repeater-v2.default"> 1249 <div class="elementor-widget-container"> 1250 <div class="dce-acf-repeater"><span class="repeater-item elementor-repeater-item-40604b1">Karen Ousey</span></div> </div> 1251 </div> 1252 <div data-dce-text-color="#686868" class="elementor-element elementor-element-10019f9 elementor-widget elementor-widget-text-editor" data-id="10019f9" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default"> 1253 <div class="elementor-widget-container"> 1254 18 September 2026 </div> 1255 </div> 1256 <div class="elementor-element elementor-element-259854c elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="259854c" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default"> 1257 <div class="elementor-widget-container"> 1258 <div class="elementor-divider"> 1259 <span class="elementor-divider-separator"> 1260 </span> 1261 </div> 1262 </div>
1263 </div> 1264 <div class="elementor-element elementor-element-d445631 elementor-widget elementor-widget-text-editor" data-id="d445631" data-element_type="widget" data-e-type="widget" data-widget_type="text-editor.default"> 1265 <div class="elementor-widget-container"> 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 cliniciansâ 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> 1272 <div class="elementor-element elementor-element-210b594 elementor-widget elementor-widget-image" data-id="210b594" data-element_type="widget" data-e-type="widget" data-widget_type="image.default"> 1273 <div class="elementor-widget-container"> 1274 <img width="800" height="534" src="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-1024x683.jpg" class="attachment-large size-large wp-image-25038" alt="" srcset="https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-1024x683.jpg 1024w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-300x200.jpg 300w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-768x512.jpg 768w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-1536x1024.jpg 1536w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-2048x1365.jpg 2048w, https://wounds-uk.com/wp-content/uploads/2026/09/pexels-alex-green-5699475-600x400.jpg 600w" sizes="(max-width: 800px) 100vw, 800px" /> </div> 1275 </div> 1276 <div class="elementor-element elementor-element-a900fc1 elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="a900fc1" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default"> 1277 <div class="elementor-widget-container"> 1278 <div class="elementor-divider"> 1279 <span class="elementor-divider-separator"> 1280 </span> 1281 </div> 1282 </div> 1283 </div> 1284 <div class="elementor-element elementor-element-5a4f690 elementor-widget elementor-widget-theme-post-content" data-id="5a4f690" data-element_type="widget" data-e-type="widget" data-widget_type="theme-post-content.default"> 1285 <div class="elementor-widget-container"> 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 professionalsâ knowledge and skills, or an organisationâs 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 Clarkeâs (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, âmoisture lesionsâ on the buttocks or general âbottom careâ. 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 donât 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 documentâs 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 â thatâs 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 cliniciansâ 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 cliniciansâ 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> 1860 </div> 1861 </div> 1862 <div data-dce-title-color="#1E2A54" class="elementor-element elementor-element-d8a7103 elementor-widget elementor-widget-heading" data-id="d8a7103" data-element_type="widget" data-e-type="widget" data-settings="{"enabled_visibility":"yes","dce_visibility_selected":"hide"}" data-widget_type="heading.default"> 1863 <div class="elementor-widget-container"> 1864 <p class="elementor-heading-title elementor-size-default"><a href="https://wounds-uk.com/wp-content/uploads/2026/09/WUK_22-3_16-23_Flen-MASD.pdf" target="_blank">â Download pdf</a></p> </div> 1865 </div> 1866 <div data-dce-advanced-background-color="#579ED820" class="elementor-element elementor-element-df485e5 elementor-widget elementor-widget-text-editor" data-id="df485e5" data-element_type="widget" data-e-type="widget" data-settings="{"enabled_visibility":"yes","dce_visibility_selected":"hide"}" data-widget_type="text-editor.default"> 1867 <div class="elementor-widget-container"> 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> 1869 </div> 1870 <div data-dce-advanced-background-color="#EAEAEA" class="elementor-element elementor-element-ea9912d elementor-widget elementor-widget-text-editor" data-id="ea9912d" data-element_type="widget" data-e-type="widget" data-settings="{"enabled_visibility":"yes","dce_visibility_selected":"hide"}" data-widget_type="text-editor.default"> 1871 <div class="elementor-widget-container"> 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 28:1035â40.</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;13:161â8.</p> 1875<p>Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77â101. <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;98:56â64</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;28:122â8.</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):602â8.</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. 1â318.</p> 1883<p>van de Klundert J, Gorissen P, Zeemering S. Measuring clinical pathway adherence. J Biomed Inform. 2010;43(6):861â72.</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> 1886 </div> 1887 </div> 1888 <div class="elementor-element elementor-element-7596348 elementor-widget-divider--view-line elementor-widget elementor-widget-divider" data-id="7596348" data-element_type="widget" data-e-type="widget" data-widget_type="divider.default"> 1889 <div class="elementor-widget-container"> 1890 <div class="elementor-divider"> 1891 <span class="elementor-divider-separator"> 1892 </span> 1893 </div> 1894 </div> 1895 </div> 1896 <div data-dce-text-color="#1E2A54" class="elementor-element elementor-element-694e9be elementor-post-navigation-borders-yes elementor-widget elementor-widget-post-navigation" data-id="694e9be" data-element_type="widget" data-e-type="widget" data-widget_type="post-navigation.default"> 1897 <div class="elementor-widget-container"> 1898 <div class="elementor-post-navigation" role="navigation" aria-label="Post Navigation"> 1899 <div class="elementor-post-navigation__prev elementor-post-navigation__link"> 1900 <a href="https://wounds-uk.com/journal-articles/building-specialist-capability-developing-a-proficiency-based-induction-for-tissue-viability-services/" rel="prev"><span class="post-navigation__arrow-wrapper post-navigation__arrow-prev"><i aria-hidden="true" class="fas fa-angle-left"></i><span class="elementor-screen-only">Prev</span></span><span class="elementor-post-navigation__link__prev"><span class="post-navigation__prev--label">Previous article</span><span class="post-navigation__prev--title">Building specialist capability: Developing a proficiency-based induction for tissue viability services</span></span></a> </div> 1901 <div class="elementor-post-navigation__separator-wrapper"> 1902 <div class="elementor-post-navigation__separator"></div>
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elementor-widget elementor-widget-icon-list" data-id="463f7aa" data-element_type="widget" data-e-type="widget" data-widget_type="icon-list.default"> 1974 <div class="elementor-widget-container"> 1975 <ul class="elementor-icon-list-items"> 1976 <li class="elementor-icon-list-item"> 1977 <a href="/category/best-practice-statements/"> 1978 1979 <span class="elementor-icon-list-icon"> 1980 <i aria-hidden="true" class="fas fa-circle"></i> </span> 1981 <span class="elementor-icon-list-text">Best practice statements</span> 1982 </a> 1983 </li> 1984 <li class="elementor-icon-list-item"> 1985 <a href="/category/case-studies/"> 1986 1987 <span class="elementor-icon-list-icon"> 1988 <i aria-hidden="true" class="fas fa-circle"></i> </span> 1989 <span class="elementor-icon-list-text">Case studies</span> 1990 </a> 1991 </li> 1992 <li class="elementor-icon-list-item"> 1993 <a href="/category/consensus-documents/"> 1994 1995 <span class="elementor-icon-list-icon"> 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 2003 <span class="elementor-icon-list-icon"> 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> 2008 <li class="elementor-icon-list-item"> 2009 <a href="/category/made-easy/"> 2010 2011 <span class="elementor-icon-list-icon"> 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> 2046 </a> 2047 </li> 2048 <li class="elementor-icon-list-item"> 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> 2069 <span class="elementor-icon-list-text">Abstracts</span> 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="{"background_background":"classic"}"> 2096 <div class="elementor-container elementor-column-gap-default"> 2097 <div data-dce-background-color="#F4F4F4" class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3267195" data-id="3267195" data-element_type="column" data-e-type="column" data-settings="{"background_background":"classic"}"> 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"> 2100 <div class="elementor-widget-container"> 2101 Related content </div> 2102 </div> 2103 <div class="elementor-element elementor-element-69fbc04 elementor-widget__width-auto elementor-fixed elementor-hidden-desktop elementor-widget elementor-widget-button" data-id="69fbc04" data-element_type="widget" data-e-type="widget" data-settings="{"_position":"fixed","sticky":"bottom","sticky_offset":"10","sticky_effects_offset":"10","sticky_on":["desktop","tablet","mobile"],"sticky_anchor_link_offset":0}" data-widget_type="button.default"> 2104 <div class="elementor-widget-container"> 2105 <div class="elementor-button-wrapper"> 2106 <a class="elementor-button elementor-button-link elementor-size-xl elementor-animation-shrink" href="#elementor-action%3Aaction%3Dpopup%3Aopen%26settings%3DeyJpZCI6Ijk4IiwidG9nZ2xlIjpmYWxzZX0%3D"> 2107 <span class="elementor-button-content-wrapper"> 2108 <span class="elementor-button-icon"> 2109 <i aria-hidden="true" class="fas fa-user-md"></i> </span> 2110 </span> 2111 </a> 2112 </div> 2113 </div> 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="{"custom_columns":"4","custom_columns_tablet":"3","custom_row_gap_tablet":{"unit":"px","size":20,"sizes":[]},"custom_row_gap_mobile":{"unit":"px","size":20,"sizes":[]},"custom_columns_mobile":"1","custom_row_gap":{"unit":"px","size":35,"sizes":[]}}" data-widget_type="posts.custom"> 2116 <div class="elementor-widget-container"> 2117 <div class="ecs-posts elementor-posts-container elementor-posts elementor-grid elementor-posts--skin-custom" data-settings="{"current_page":1,"max_num_pages":"5","load_method":"","widget_id":"99e9491","post_id":25036,"theme_id":53,"change_url":false,"reinit_js":false}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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="{"background_background":"classic"}"> 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
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elementor-element elementor-element-124b6fb" data-id="124b6fb" data-element_type="column" data-e-type="column" data-settings="{"background_background":"classic"}"> 2237 <div class="elementor-widget-wrap elementor-element-populated"> 2238 <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"> 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> 2246 </div> 2247 </div> 2248 </div> 2249 </section> 2250 </div> 2251 </article> 2252 <article id="post-25012" class="elementor-post 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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="{"enabled_visibility":"yes","dce_visibility_selected":"hide"}" 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">â 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"> 2936 </span> 2937 </div> 2938 </div> 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> 2947 </div> 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> 2981 </div> 2982 </div>
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If you continue without changing your browser settings, we’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"> 3019 <div class="elementor-container elementor-column-gap-default"> 3020 <div class="elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-473fe4f" data-id="473fe4f" data-element_type="column" data-e-type="column"> 3021 <div class="elementor-widget-wrap elementor-element-populated"> 3022 <div class="elementor-element elementor-element-8cfe6b9 elementor-cta--valign-top elementor-cta--skin-classic elementor-animated-content elementor-widget elementor-widget-call-to-action" data-id="8cfe6b9" data-element_type="widget" data-e-type="widget" data-widget_type="call-to-action.default"> 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 â </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"> 3043 <div class="elementor-widget-wrap elementor-element-populated"> 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 â </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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3311<script id="ecs-slider-js" src="https://wounds-uk.com/wp-content/plugins/ele-custom-skin/modules/container-layout/assets/js/ecs-slider.js?ver=4.3.11"></script>
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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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>
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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>
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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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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>
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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>
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3343<script id="wp-hooks-js" src="https://wounds-uk.com/wp-includes/js/dist/hooks.js?ver=f0f188028580e8dc1255"></script>
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3344<script id="wp-i18n-js" src="https://wounds-uk.com/wp-includes/js/dist/i18n.js?ver=1dfe7db3940c23ea9216"></script>
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3345<script id="wp-i18n-js-after"> 3346wp.i18n.setLocaleData( { 'text direction\u0004ltr': [ 'ltr' ] } ); 3347//# sourceURL=wp-i18n-js-after 3348</script>
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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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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>
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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>
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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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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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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) == ð« 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>
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