My first simulation, I took a photo of a lower extremity injury from the internet, printed it in color, and took a pair of pants, blood soaked them and allowed them to dry. Also had a pad under the manikin's leg that I had soaked in simulated blood and let dry. This was an ER patient, with fairly new students. They were reluctant, but DID cut the pants, and found the pretty realistic "wound". The photo worked well, with the other items used.