Wound care across diverse skin tones in the community nursing context: a critical narrative analysis

Wound assessment in the UK community setting remains heavily reliant on visual cues, such as erythema, which are unreliable in darker skin tones. This continued reliance on a light-skin norm represents a form of hidden systemic bias that risks delayed diagnosis and avoidable harm for a growing segment of the population. This article draws on empirical and conceptual literature to develop a critical narrative analysis of how skin tone diversity affects wound assessment, diagnosis and management in UK community nursing practice. It synthesises evidence on diagnostic delays, critiques the inadequacy of the blanching test and outlines a multisensory, equity-focused assessment framework. By proposing strategies across clinical practice, education and policy, this article challenges the status quo, arguing that true safety requires not just new tools but the dismantling of embedded racial biases within healthcare structures.