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Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII–WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted.

Skin tears are a significant problem for patients and the nurses who treat them. Estimates of their prevalence differs around the world, but there is strong evidence to suggest that they occur more frequently than pressure ulcers. In the past few years there has been an increased focus and research into skin tears, and the International Skin Tear Advisory Panel has developed internationally recognised best practice recommendations in this important field for the global wound care community. This article will review the most current research and best practice recommendations for the prediction, prevention, assessment and treatment of skin tears.

Background: skin tears are acute wounds that are frequently misdiagnosed and under-reported. A standardized and globally adopted skin tear classification system with supporting evidence for diagnostic validity and reliability is required to allow assessment and reporting in a consistent way. Objectives To measure the validity and reliability of the International Skin Tear Advisory Panel (ISTAP) Classification System internationally. Methods: a multicountry study was set up to validate the content of the ISTAP Classification System through expert consultation in a two-round Delphi procedure involving 17 experts from 11 countries. An online survey including 24 skin tear photographs was conducted in a convenience sample of 1601 healthcare professionals from 44 countries to measure diagnostic accuracy, agreement, inter-rater reliability and intrarater reliability of the instrument. Results: a definition for the concept of a 'skin flap' in the area of skin tears was developed and added to the initial ISTAP Classification System consisting of three skin tear types. The overall agreement with the reference standard was 0 center dot 79 [95% confidence interval (CI) 0 center dot 79-0 center dot 80] and sensitivity ranged from 0 center dot 74 (95% CI 0 center dot 73-0 center dot 75) to 0 center dot 88 (95% CI 0 center dot 87-0 center dot 88). The inter-rater reliability was 0 center dot 57 (95% CI 0 center dot 57-0 center dot 57). The Cohen's Kappa measuring intrarater reliability was 0 center dot 74 (95% CI 0 center dot 73-0 center dot 75). Conclusions: the ISTAP Classification System is supported by evidence for validity and reliability. The ISTAP Classification System should be used for systematic assessment and reporting of skin tears in clinical practice and research globally. What's already known about this topic? Skin tears are common acute wounds that are misdiagnosed and under-reported too often. A skin tear classification system is needed to standardize documentation and description for clinical practice, audit and research. What does this study add? The International Skin Tear Advisory Panel Classification System was psychometrically tested in 1601 healthcare professionals from 44 countries. Diagnostic accuracy was high when differentiating between type 1, 2 and 3 skin tears using a set of validated photographs., International Skin Tear Advisory Panel (ISTAP)