Moulage

The importance of realistic, immersive training exercises has become increasingly clear to me over time as I have trained and been trained in medical and trauma care. Students respond more realistically and retain skillsets better when trained in a higher-fidelity environment than a classroom. Moulage contributes greatly to this type of learning environment. While it can be considered time consuming, resource intensive, and messy, there is a visceral reaction when students see a wound like that pictured here. Working through that response and falling back to the tools offered through education and training is the definition of stress innoculation.

The wound pictured was created by the SpecMed team with liquid latex, toilet paper, and simulated blood. Wound creation with liquid latex is reltively simple, and the created product can be reused many times. The process consists of laying down a base layer of latex, placing torn or crumpled toilet paper in the latex to approximate wound edges and texture, and then adding several layers of latex to seal and add flesh to the wound. Color can then be added with paint once the prosthetic has dried.

Simulated blood can be tricky, as generally a choice needs to be made between a non-ingestible product or one that stains. I prefer to use commercially available blood for any wounds involving the head or face, as it is nontoxic, but it will stain skin and clothing. For wounds in other areas of the body, a blood mixture made with dish soap, water, and food coloring works well–mixing blue and orange dish soap creates a product that can easily be tweaked with food coloring to achieve a realistic color. This tends to wash out reliably, though care must be taken not to leave it on the skin for long periods of time as it is caustic over time.

For more excellent ideas in wound simulation, the folks at simulation podcast offer a
moulage reference sheet for your consideration.