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Reusable venous ulcer for use on mannequin or Standardized Participant

  Submitted by: Jeff Carmack on July 16, 2016
  HomeGrown Solution Number: 285
Identification of the Problem
We needed a higher fidelity manner of simulating a venous wound ulcer on a standardized participant without having to reapply moulage for multiple runs of the same scenario spanning multiple days.
Unique Idea
Create a reusable silicone-based leg ulcer (molded form mannequin leg ulcer using silicone per package instructions), realistically painted and applied to SP with panty-hose.
Create a reusable venous ulcer wound for use with a mannequin or an SP.
1. Liquid silicone product of choice
2. A wound to make mold from
3. Various colors of nail polish to match desired skin tones and typical wound bed colors (See staged picture collage for recommended colors)
4. also need a clear top/base coat polish
5. Panty-hose and/or stretchy leggings (various sizes) of various colors to match skin tone of SP and polish colors used (cut legs into tube-like pieces/open at both ends)
6. Super glue and Tape (optional)
Steps to Creating the Solution
1. Protect work surface areas from all liquid products involved in this project
2. Using an existing wound (we used a venous ulcer mannequin leg) of your choice and a liquid silicone product of your choice, create a silicone mold of the 3-D wound desired. (See silicone product details for specific instructions). Be sure to make a thin layered mold of the wound so that it lays flatter on the SP’s skin, but thick enough to remain durable and hold desired shape or depth. (See Prototype Picture, Pictures A, B, & C)
3. See first picture for finished silicone mold before color applied. See Picture D Apply clear base coat directly on silicone wound. Repeat several times to build up layers. Allow each coat to dry before applying the next.
4. Apply a couple of layers of the desired skin tone layer, allowing each to dry before applying the next. Apply respective colors to wound bed and wound edges (See staged picture collage for color application)
5. Once all layers are thoroughly dry, the new wound may be used in 1 of 2 ways: a. Leaving the polish layer on the silicone mold, place the wound on the SP’s skin in the desired location, using a panty-hose sleeve cut into a tube shape (open on both ends) i. Pull the panty-hose taunt. Use tape to secure the panty-hose edges at both edges to the SP. ii. Cut a hole in the panty-hose directly over the concavity of the wound (See picture). Use superglue to secure the edges of the panty-hose hole to the edges of the wound. iii. May need to superglue polish layer to silicone mold if you intend to use over and over. Polish layer tends to pull away from silicone fairly easily. iv. Advantages/Disadvantages: This method preserves the concavity of the wound, but ties up your mold preventing you from making other wounds. (See single picture with panty-hose overlay)
6. b. The second method is to carefully peel the polish layer off of the silicone mold. This allows you to use the mold to make several wounds from the mold. i. These wounds can be taped to the SP directly onto skin or over flesh colored leggings. Panty-hose can then be applied over SP skin or leggings to increase the realistic effect. (See Pictures E & H) ii. Advantages/Disadvantages: This method tends to flatten the wound with repeated use. Using this method allows you to make multiple wounds with the same mold. A new wound can be made in about 30-45 minutes (including dry time between layers).