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In wound care, optimising treatment and outcomes for the individual patient depends on accurate assessment and diagnosis, for which knowledge of the signs and symptoms across skin tones is essential. There has, in the past, been a distinct lack of evidence around skin tones and wound care, and those persons who have darker skin tones are at greater risk of being misdiagnosed, especially when it comes to higher category pressure ulcers/injuries and tissue type (Oozageer Gunowa, 2022).

A full assessment should involve a thorough inspection of the skin, and should include the patient’s baseline skin tone. This is a necessity so that any changes to the patient’s skin can be monitored and identified early. Lack of early identification of skin changes can lead to vital signs being missed, which could lead to skin and tissue breakdown and damage (Wounds UK, 2021).

The 2021 Best Practice Statement addressing skin tone bias in wound care is a validated skin tool showing a range a skin tones.

(Adapted from Wounds UK, 2021)

When undertaking and reporting an assessment, it is important to remember that skin tone is separate from race – e.g. not all people classified as Black have dark skin tones. Language used in the medical context simply needs to be accurate rather than carrying any political, ethnic or social connotations.

Using the skin tone tool can be more effective than asking the patient to select what may be a subjective term to describe their own skin tone. In cultures where there is a light skin bias, or colourism is an issue, may affect how patients view and describe their skin tone. It is also important to note that skin tone may differ across different areas of the body (Wounds UK, 2021).

Employing touch, will assist in acquiring an accurate assessment, together with asking the person their perspective and feelings regarding their wound and skin changes.