A nursing specialty known as wound, ostomy, and continence nursing deals with the care of patients with both acute and chronic wounds, ostomies (those who have had some sort of bowel or bladder diversion), and incontinence disorders (those with issues of bladder control, bowel control, and associated skin care). Wound, ostomy, and continence nurses are common titles for nurses who practice in this area of nursing (WOC nurses). They manage the care of these patients, whose requirements are frequently complex, using knowledge and abilities based on evidence. The Wound, Ostomy and Hygiene Nursing Certification Board in the United States offers certification in this field.