NSWOCC® and ISTAP™ Launch New Evidence-Based Skin Tear Assessment and Classification Toolkit for Indigenous Skin Tones
Updated: 7 days ago
Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC®), in collaboration with the International Skin Tear Advisory Panel (ISTAP™), is pleased to announce the launch of a new Evidence-Based Skin Tear Assessment and Classification Toolkit for Indigenous Skin Tones, developed to support culturally safe, equitable, and person-centred skin tear assessment and management for Indigenous Peoples across Canada.
The toolkit consists of three complementary resources:
ISTAP™ Indigenous Skin Tear Decision Algorithm
ISTAP™ Skin Tear Risk Assessment Pathway for Indigenous People
ISTAP™ Assessment and Treatment Pathway for Indigenous People with Skin Tears
These resources are now freely available through the ISTAP website at: https://www.skintears.org/resources
The new toolkit was officially launched during ISTAP World Without Skin Tears Day 2026 on April 9, 2026, through the presentation "Adapting the Skin Tear Classification Tool to Support Indigenous Cultural Safety." The presentation featured:
Michelle Buffalo, BScN, RN, NSWOC, WOCC(C) (Canada)
Bev Smith, BScN, RN, NSWOC (Canada)
Dr. Kevin Woo, PhD, RN, FAPWCA, NSWOC, WOCC(C), FNSWOC (Canada)
The presentation recording is available on demand at:
The project was led by NSWOCC and ISTAP with support from Indigenous Services Canada and brought together an expert panel of Indigenous nurses and wound, ostomy, and continence specialists working closely with Indigenous communities. The panel included:
Michelle Buffalo, BScN, RN, NSWOC, WOCC(C) – Alberta
Bev Smith, BScN, RN, NSWOC – Alberta
Amanda Sowiak, BScN, RN, NSWOC, WOCC(C) – Alberta
Jocelyne Bergen, RN, BScN – Yukon
Tina Beckerton, BScN, RN, NSWOC, WOCC(C) – British Columbia
Denise Lalonde-Niccoli, BScN, RN, NSWOC, WOCC(C) – British Columbia
Jer Caul, MClinSc-WH, BScN, RN, NSWOC, WOCC(C) – Ontario
Josée Sénéchal, MScCH-WC, BScN, RN, NSWOC – Ontario
The project focused on culturally adapting existing ISTAP resources to better reflect the language, culture, lived experiences, and health care realities of Indigenous Peoples. Cultural adaptation involves validating and modifying knowledge tools within the cultural context in which they will be used. Through expert review, consultation, and validation, the panel identified opportunities to strengthen cultural safety, acknowledge traditional knowledge and medicines, address social determinants of health, and promote health equity within skin tear prevention and management pathways.
The resulting toolkit incorporates considerations such as traditional healing practices, cultural safety, trust in the health care system, environmental health, transportation barriers, access to resources, and other social determinants of health that may influence skin health and wound healing.
NSWOCC and ISTAP extend their sincere gratitude to the expert panel members, validation participants, Indigenous Services Canada, and all those who contributed their expertise and lived experiences to this important initiative.
Together, we continue to advance culturally safe wound care practices and work toward a world without skin tears.
The focus on assessment and classification for Indigenous skin tones is the part that stuck with me; wound training often uses examples that don’t represent darker skin.
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I’d be interested to see how the toolkit translates into bedside use where lighting and access vary.
What stands out is how the toolkit adapts skin tear assessment to Indigenous skin tones instead of assuming standard erythema cues translate evenly. It reminds me of pressure injury staging updates that finally acknowledged darker skin presentations.
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Will rollout training address those colour and lighting differences?
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