Wound, ostomy and continence nursing is a nursing tri-specialty involved with the treatment of patients with acute and chronic wounds, patients with an ostomy (those who have had some kind of bowel or bladder diversion), and patients with continence conditions (those with bladder and bowel control and associated skin care issues). WOC nurses use evidence-based knowledge and skills to manage these complex patients. Nurses in this specialty are often referred to as wound, ostomy, continence nurses (WOC) nurses. In the United States, certification is available for this specialty from the Wound, Ostomy and Continence Nursing Certification Board. There are additional organizations that offer varying levels of certification in this field.