I tried using this in realism with various garry's mod collections and reshade presets and it looked pretty good, at least it did for me. I made the wound textures with a cartoony and simple style as its well Simple Small Wounds, it isnt really fit for realism but it can do a good job for small wounds. Ill always try to make addons like this in the future and hopefully better too.

I think the resolution of the decal is partially related to the decal limit.
it looks like its a standard resolution but the decal width and height has been set to something low, which does seem to increase it slightly already.
but if the decal itself is very low res, it wouldn't be much of a sacrifice considering its for afar, and it might even look better if its more blurry.
and hopefully it would increase it even further.