Advanced Wound Task Trainers Instructions

Determine the length and depth of the burn to calculate below:

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³.

11.25in³ x 16mL/in³ = 180 mL

Open and pour the calculated amount of Dragon Skin™ FX Pro Part A into a small measuring cup. Stir Part A.

Open, pour, and stir (with a different stirring tool) equal parts Part B into a separate small measuring cup.

Once measured, Dragon Skin Part B can be poured into a disposable cup large enough to hold the final amount (e.g., for 3x5” mould, 180ml).

If using, add red-brown tone Silc pig™ pigment(s) to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks to give a bloody colour.

TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT: Now that A&B are combined, you must pour it within 12 minutes, or it will begin to set / not pour.

Start by adding a few drops of Thivex™ or other silicone thickener. Aim for a thickness that will hold to the side of the cup for several seconds. The goal is that it does not run down the rounded surface when poured.

Add more drops as needed and mix thoroughly.

Slowly pour silicone on to rounded surface and spread using tongue depressor.

Dab lightly for a few seconds while it sets to create textured effect on silicone.

NOTE: If applying simulated burn to arms or legs pour silicone onto secure rounded surface.

After approximately 30-40 minutes of curing, remove silicone from the surface. This wound can now be placed on manikins or standardized patients for repeated use.

OPTIONAL: to amplify your look, add fake soot, fake blood, and additional redness with alcohol-based make-up to the SP or manikin to create a realistic burnt look.

Line your flat surface with wax paper. Examples of a suitable flat surface would be a kitchen counter, stainless steel surface, etc. Alternatively, use a large flat-bottomed container as your work surface with wax paper (e.g. cookie sheet).

TIP: The Smooth Cast™ creates heat, so ensuring wax paper with a sturdy surface will potentially minimize any damage to your work surface.

On a flat surface, form clay that is slightly raised approximately 0.4-0.6”, the raised portion will represent your wound.

Try to make the transition from clay to work surface smooth, so the end product appears more natural on skin or on a mannequin.

TIP: Keep in mind that the clay design will be what the finished silicone looks like. Take time to clean it up if needed.

TIP: Dipping a finger in water and then rubbing it on the clay can give it a smoother texture. Just be careful not to use too much water.

On a flat surface, roll clay into long strips about 1.5-2” wide, and ¼” thick. The length of your pieces will be dependent on the size of your wound.

Make a wall around the wound, leaving at least 1cm between the wound and the wall. Make sure no gaps appear that could let the Smooth Cast™ seep out.

TIP: You can roll out the clay using the Smooth Cast™ bottles (securely sealed) or a rolling pin.

To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of Smooth Cast™ (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³.

11.25in³ x 16mL/in³ = 180 mL

Step 4A: Open and stir Smooth Cast™ Part A into a small measuring cup. With a different stirring tool, do the same for equal parts Part B into a separate small measuring cup. You need enough to completely cover the clay wound by at least a few millimetres.

Step 4B: Combine Parts A & B in a large cup and pour into clay walls. Ensure there are no leaks, and cover any existing leaks with more clay.

Wait 10-15 minutes to let the Smooth Cast™ cure. It will become warm to the touch and opaque.

4B

Once the Smooth Cast™ has hardened, you can peel away the clay which can also be reused.

TIP: You may notice some thin pieces of Smooth Cast™ in the clay. You can take these pieces out if you plan on reusing the clay.

The mould may have sharp edges or flashing (thin pieces of plastic). If so, use an exacto knife or scalpel to trim away any excess Smooth Cast™.

TIP: Using a toothbrush to scrub with warm water can help remove clay that may still be stuck to the mould.

Add a small piece of plastic into the cavity of the cured mold. This should be a solid piece of plastic. (Can also use a clay log if no sufficient material exists).

Stick the plastic piece to the mold using a bit of clay. This will later be removed to create the cavity to add the drainage into.

If you decided to use a different size mould (i.e., not 3x5”) you need to determine how much silicone you need to fill your mould.

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³.

11.25in³ x 16mL/in³ = 180 mL

Step 8A : Open and stir Dragon Skin™ Part A in a small disposable measuring cup. With a different stirring tool, do the same for Part B in a different measuring cup.

Step 8B : Once measured, Dragon Skin™ Part B can be poured into a disposable cup large enough to hold the final amount.

Step 8C : Add flesh tone pigment(s) to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks. TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Step 8D : Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT : Now that A & B are combined, you must pour it within 12 minutes, or it will begin to set.

8C:

8D:

Pour the prepared silicone with the skin tone pigment of your choice into the mold.

Note: the plastic piece should be covered by at least a couple millimeters of silicone. If you notice leaks, plug them with additional clay or tape. Do not over pour and cause an overflow of the silicone.

OPTIONAL Reviewer note : If planning to use the task trainer multiple times, it may be beneficial to pour halfway, add a Power mesh layer, as in Step 7 of the Suture and Staple pad task trainer. This will give the sutures something to ‘bite’ into during Step 13.

Wait 40 mins (for a 3” x 5” wound) to cure. For other sizes, follow package instructions on wait time.

Once removed from mould, touch up any frayed edges with scissors if desired.

TIP: Baby powder can be used to remove the silicone task trainer to make it less sticky and easy to remove.

Carefully remove the plastic piece from the mould, revealing the cavity that was inside.

TIP: If having difficulty removing plastic piece, use scalpel to lengthen incision.

Mix petroleum jelly with yellow food coloring in a small cup.

Take a syringe (50cc catheter tip, or 10cc or 20cc Luer Lock work well), and remove the plunger. Then, using a tongue depressor, scoop the petroleum jelly into the syringe.

Replace the plunger and push contents to the end. For the Luer Lock syringe, add a blunt tip needle.

Add stitches to the incision using any suture technique you prefer to partially close wound.

OPTIONAL: Add alcohol activated make-up to make the top of the wound look infected

Insert the syringe (with or without blunt tip cannula) into the stitched cavity to insert the pus-like substance. Push slowly to reduce pressure build-up.

Line your flat surface with wax paper. Examples of a suitable flat surface would be a kitchen counter, stainless steel surface, etc. Alternatively, use a large flat-bottomed container as your work surface with wax paper (e.g. cookie sheet).

TIP: The Smooth Cast™ creates heat, so ensuring wax paper with a sturdy surface will minimize the potential of any damage to your work surface.

Cut a piece of IV tubing a few inches longer than the anticipated length of your wound.

On a flat surface, form clay around IV tubing. Allow 0.2” thickness above tubing and secure base around tubing.

TIP: Try to make the transition from clay to work surface smooth, so the end product appears more natural on skin or on a mannequin. Dipping a finger in water and then rubbing it on the clay can give it a smoother texture. Just be careful not to use too much water.

Once satisfied with structure, carefully wiggle out tubing from the clay, so as not to disturb the clay cavity formed.

With clay shaping tools, add details such as incision line, suture scarring, etc. Keep in mind that the clay design will be what the finished silicone looks like. Take time to clean it up if needed.

TIP: Dipping a finger in water and then rubbing it on the clay can give it a smoother texture. Just be careful not to use too much water.

On a flat surface, roll clay into long strips about 1.5-2” wide, and ¼” thick. The length of your pieces will be dependent on the size of your wound.

Make a wall around the wound, leaving at least 1cm between the wound and the wall. Make sure no gaps appear that could let the Smooth Cast™ seep out.

TIP: You can roll out the clay using the Smooth Cast™ bottles (securely sealed) or a rolling pin.

To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of Smooth Cast™ (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³.

11.25in³ x 16mL/in³ = 180 mL

Step 6A: Open and stir Smooth Cast™ Part A in a small measuring cup. With a different stirring tool, do the same for equal parts Part B in a different cup. You need enough to completely cover the clay wound by at least a few millimetres.

Step 6B: Combine Parts A & B in a large cup and pour into clay walls. Ensure there are no leaks, and cover any existing leaks with more clay.

Wait 10-15 minutes to let the Smooth Cast™ cure. It will become warm to the touch and opaque.

6B

Once the Smooth Cast™ has hardened, you can peel away the clay which can also be reused.

TIP: You may notice some thin pieces of Smooth Cast™ in the clay. You can take these pieces out if you plan on reusing the clay.

The mould may have sharp edges or flashing (thin pieces of plastic). If so, use an exacto knife or scalpel to trim away any excess Smooth Cast™.

TIP: Using a toothbrush to scrub with warm water can help remove clay that may still be stuck to the mould.

Carefully remove clay from between the IV channel and the mould itself. (No clay should remain).

TIP: A toothbrush and warm water can also get rid of excess clay.

Once the clay is all removed, using sharp snips or scissors, create a small gap in the tubing channel nearest the top of the mould (see video).

This allows the silicone to form around it and for you to securely remove the silicone after curing

If you decided to use a different size mould (i.e., not 3x5”) you need to determine how much silicone you need to fill your mould.

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³

11.25in³ x 16mL/in³ = 180 mL

Step 11A : Open and stir Dragon Skin™ Part A in a small disposable measuring cup. With a different stirring tool, do the same for Part B in a different measuring cup.

Step 11B : Once measured, Dragon Skin™ Part B can be poured into a disposable cup large enough to hold the final amount.

Step 11C : Add flesh tone pigment(s) to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks.

TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Step 11D : Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT : Now that A & B are combined, you must pour it within 12 minutes, or it will begin to set.

11C:

11D:

Pour the prepared silicone with the skin tone pigment of your choice into the mould, making sure to cover the IV tubing channel by at least a couple millimeters. Be sure to not overpour silicone.

Wait 40 mins (for a 3” x 5” wound) to cure. For other sizes, follow package instructions on wait time.

Carefully remove the edges of the silicone mould first.

Once the edges are unstuck from the mould, carefully pull out the appliance following the path of the solidified IV channel (see video).

TIP: applying baby powder with a brush (see video) will make this process easier and more likely to be successful without tears.

Create a small incision using scissor or scalpel where the gap in the IV tubing channel was initially.

This will allow you to re-establish a complete tubing channel.

Get the IV extension set with Luer lock on either end. Cut off the ‘male’ end of the tubing, as you will need the ‘female’ end to attach the syringe.

Fill 20-60cc Luer-lock syringe with desired amount of water and red food colouring for simulated blood.

Attach syringe to female end of IV extension tubing.

TIP: Consider attaching multiple extension sets or long extension sets to be further away from bleeding wound to create distance between you and the task trainer/learner.

Thread IV extension tubing through the wound module gap you had just created.

TIP: You can use baby powder to reduce friction while inserting IV tubing.

Push on syringe to release simulated blood.

1A: Line your flat surface with wax paper. Examples of a suitable flat surface would be a kitchen counter, stainless steel surface, etc. Alternatively, use a large flat-bottomed container as your work surface with wax paper (e.g. cookie sheet).

TIP: The Smooth Cast™ creates heat, so ensuring wax paper with a sturdy surface will potential minimize any damage to your work surface.

1B: On a flat surface, form the ‘positive’ (i.e. inverse) of the tunneling.
Form your clay to the desired height/depth of the tunnel.

1C: Complete textured look on clay surface. Try to make the transition from clay to work surface smooth, so the end product appears more natural on skin or on a manikin. Keep in mind that the clay design will be what the finished silicone looks like. Take time to clean it up if needed.

TIP: Dipping a finger in water and then rubbing it on the clay can give it a smoother texture. Just be careful not to use too much water.

1C:

On a flat surface, roll clay into long strips about 1.5-2” wide, and ¼” thick. The length of your pieces will be dependent on the size of your wound

Ideally using clay, make a wall around the wound, leaving at least 1cm between the wound and the wall. Make sure no gaps appear that could let the silicone to seep out.

TIP: You can roll out the clay using the silicone bottles (securely sealed) or a rolling pin.

If you decided to use a different size mould (i.e., not 3x5”) you need to determine how much silicone you need to fill your mould.

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³

11.25in³ x 16mL/in³ = 180 mL

Step 4A : Open and stir Dragon Skin™ Part A into a small measuring cup. With a different stirring tool, do the same for Part B in a different small measuring cup.

Step 4B : Once measured, Dragon Skin™ Part B can be placed into a disposable cup large enough to hold the final amount.

Step 4C : Add pigment(s) as desired to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks.

TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Step 4D : Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT : Now that A & B are combined, you must pour it within 12 minutes, or it will begin to set.

4C:

Pour the prepared silicone with the skin tone pigment of your choice into the clay walls. If you notice leaks, plug them with additional clay or tape.

Wait 40 mins (for a 3” x 5” wound) to cure. For other sizes, follow package instructions on wait time.

Once cured, your silicone mold should look something like the photo to the right.

NOTE: You could use this appliance as is, the steps below all for a more realistic feel to the appliance

To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of Smooth Cast™ (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³

11.25in³ x 16mL/in³ = 180 mL

Step 7A: Open and stir Smooth Cast™ Part A in a small measuring cup. With a different stirring tool, do the same for equal parts Part B in a small measuring cup. You need enough to completely You need enough to completely cover the inside tunnel created by at least a few millimetres.

Step 7B: Combine Parts A & B in a large cup and pour into silicone mould. Ensure you do not overpour.

Wait 10-15 minutes to let the Smooth Cast™ cure. It will become warm to the touch and opaque.

7B

Pull out Smooth Cast mould and add to bowl.

Secure the Smooth Cast mould with clay.

If you decided to use a different size mould (i.e., not 3x5”) you need to determine how much silicone you need to fill your mould.

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³

11.25in³ x 16mL/in³ = 180 mL

Step 10A : Open and stir Dragon Skin™ Part A in a small measuring cup. With a different stirring tool, do the same for Part B in a small measuring cup.

Step 10B : Once measured, Dragon Skin™ Part B can be poured into a disposable cup large enough to hold the final amount.

Step 10C : Add red-brown tone pigment(s) to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks.

TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Step 10D : Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT : Now that A & B are combined, you must pour it within 12 minutes, or it will begin to set.

10C:

10D:

Start by adding a few drops of Thivex™ or other silicone thickener. Aim for a thickness that will hold to the side of the cup for several seconds.

The goal is that it does not run down the Smooth Cast™ mould when poured.

Add more drops as needed and mix thoroughly.

Apply silicone to the Smooth Cast™ mould with tongue depressor or stir stick.

Make sure any part that would be ‘under skin’ is covered by the thickened silicone.

If you decided to use a different size mould (i.e., not 3x5”) you need to determine how much silicone you need to fill your mould.

16 ml of silicone (8 ml each of parts A and B) will make 1in³ volume (16mL/in³).

E.g., To make a 0.75” thick layer in a 3x5” mould, you will require 180 mL of silicone (90ml each of parts A and B).

3/4” x 3” x 5” = 11.25in³

11.25in³ x 16mL/in³ = 180 mL

Step 14A : Open and stir Dragon Skin™ Part A into a small measuring cup. With a different stirring tool, do the same for Part B in a different small measuring cup.

Step 14B : Once measured, Dragon Skin™ Part B can be poured into a disposable cup large enough to hold the final amount.

Step 14C : Add flesh tone pigment(s) to Part B using a disposable toothpick or stir stick, and stir vigorously for 15 seconds/until completely combined without streaks.

TIP: A little goes a long way. Start with a small amount of pigment; if you need more, add it, and stir again before adding Part A.

Step 14D : Add Part A to Part B and mix vigorously for 15 seconds / until completely combined without streaks.

IMPORTANT : Now that A & B are combined, you must pour it within 12 minutes, or it will begin to set.

14C:

14D:

Pour the prepared silicone with the skin tone pigment of your choice into the bottom of the mould, about half-way.

Add a few drops of Thivex™ to the remaining Dragon Skin™ silicone in your cup, and pour the rest into the bowl.

Mix the now thickened silicone in the bowl with the Smooth Cast™ mould.

Brush the thickened Thivex™ up the walls of the bowl using a paint brush.

Ensure there is silicone covering every part of the bowl.

Add 2 parts ‘Part A’ of Soma Foama™ to a large disposable cup with stir stick.

Add 1 part ‘Part B’ of Soma Foama™ to different large disposable cup with stir stick.

Calculation instructions available on bottle.

Mix together parts A & B of Soma Foama 15™ and add to bowl.

The Soma Foama 15™ will expand to cover wound.

NOTE: if the expanded Soma Foama 15™ does not fully cover tunnel, you can mix another batch and add on top, the Soma Foama 15™ combines well together.

Wait for foam to cure. Will be solid and more opaque.

Once foam is cured, cut away the excess foam to create a flat surface using scizzors.

Pull out the silicone/foam mould from the bowl, and remove the inner Smooth Cast™ mould inside.

Remove any remaining excess foam, being careful not to cut at the silicone.

Mix a small amount (~15mL) of Dragon Skin™ silicone again, using same guiding instructions as above, mixing Part B with flesh tone pigment.

Pour mixed Dragon Skin™ silicone on flat surface with taped down wax paper (or stainless steel work surface) and spread out to cover bottom of appliance created.

Carefully place appliance on top of silicone.

Using a tool spread silicone from the work surface to the sides of the appliance. This will enclose the appliance.

Wait 10-20min to cure and then trim away the excess silicone.

Your wound task trainer is now complete.