Introduction

Culturally and Linguistically Appropriate Services (CLAS) support safe, effective, and equitable wound care. The National CLAS Standards, developed by the U.S. Department of Health and Human Services (HHS) Office of Minority Health, outline how healthcare services should be delivered in a manner that respects patients’ cultural health beliefs, preferred languages, and communication needs¹. For wound care clinicians, applying CLAS principles helps ensure that clinical decisions and care plans are understood, acceptable, and actionable for diverse patient populations. 

This topic provides an overview of CLAS principles applied to wound care.

Definitions

• Culturally and linguistically appropriate services (CLAS): Services that are respectful of and responsive to individual cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs and employed by all members of an organization (regardless of size) at every point of contact.
• Social determinants of health: The conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The social determinants of health are mostly responsible for health inequities — the unfair and avoidable differences in health status seen within and between countries.
• Cultural and linguistic competency: The capacity for individuals and organizations to work and communicate effectively in cross-cultural situations through the adoption and implementation of strategies to ensure appropriate awareness, attitudes, and actions and through the use of policies, structures, practices, procedures, and dedicated resources that support this capacity.
• Cultural competency: A developmental process in which individuals or institutions achieve increasing levels of awareness, knowledge, and skills along a cultural competence continuum. Cultural competence involves valuing diversity, conducting self-assessments, avoiding stereotypes, managing the dynamics of difference, acquiring and institutionalizing cultural knowledge, and adapting to diversity and cultural contexts in communities.
• Linguistic competency: The capacity of individuals or institutions to communicate effectively at every point of contact. Effective communication includes the ability to convey information — both written and oral — in a manner that is easily understood by diverse groups, including persons of limited English proficiency, those who have low literacy skills or who are not literate, those having low health literacy, those with disabilities, and those who are deaf or hard of hearing.
• Cultural humility: A reflective process of understanding one’s biases and privileges, managing power imbalances, and maintaining a stance that is open to others in relation to aspects of their cultural identity that are most important to them. Cultural competency includes the commitment to practicing cultural humility.

Relevance

• Wound care depends on accurate assessment, clear communication, and patient adherence to treatment plans that often require ongoing self-care. Chronic wounds - such as diabetic foot ulcers, venous leg ulcers, arterial ulcers, and pressure injuries - often affect populations experiencing health disparities and limited English proficiency. 
• Cultural beliefs about wounds, pain, body exposure, and traditional healing practices can influence how patients report symptoms and follow treatment recommendations. Language barriers may further affect wound assessment, informed consent, and education, increasing the risk of delayed healing and complications.
• Using culturally responsive communication and appropriate language access in wound care improves patient understanding, engagement, and adherence. When wound care instructions are aligned with patients’ language preferences and cultural context, patients are more likely to perform dressing changes correctly, recognize signs of infection, and follow offloading, compression, and nutrition recommendations³.
• Incorporating CLAS principles into routine wound care practice supports patient safety, reduces disparities, and promotes optimal healing outcomes.