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Wurm has very advanced item (or object) management. Almost all items are player-made from raw materials gathered or extracted from the surrounding nature or creatures. Every item has weight, damage, quality level, size, possible temperature, possible enchantments, a custom description, and other types of data that can make every item very unique and almost seem alive.

Items can be used to build other items and structures like houses, guard towers, roads, and many other things.