Physiology-driven reversible dynamic synthetic tissue model for responsive moulage in infected wound training.

Misidentification of dermatologic manifestations of systemic infection can lead to life-threatening developments including sepsis. Training medical providers to accurately identify and respond to infections using simulation could reduce these rates. Moulage of infections are static and require a manual "scene change" during simulation scenarios. A high-fidelity, automated physiology-driven dynamic infection model was developed using the Modular Healthcare Simulation and Education platform that physically changes to simulate the progression of an infected wound. The silicone model was designed using resistive wire, wax actuators, and thermochromic powder. The resistive wire heats the wax, resulting in focal edema, skin warmth, and erythema that reverses with proper recognition and treatment. Without external treatment, purulence is released, and the patient will develop septic physiology. To evaluate the physiological realism and training value of the model, a survey of physicians was conducted using a five-point Likert scale of agreement with 5 being the highest rating. When asked to rate the realism of the model, the mean response was 4.1 ± 0.7. When asked if they thought the model had value for training infection identification, the mean response was 4.3 ± 0.9. Finally, when asked if the dynamic aspect would improve the simulation, the mean response was 4.7 ± 0.6. The dynamic infection model is functional and appealing for practitioners to assist in the early detection of infection. The use of a dynamic training model could potentially be used to replicate other dermatologic manifestations of systemic disease processes and improve medical training.