I have a character who gets stabbed by a sharp knife in his lower arm. Clean cut, but it is rather deep. It got all the right treatment, so I do not expect it to take too long, but how long would it take for the worst pain to go away? Would it still sting the next day? Or only if you use it too much? Or am I underestimating this and will it still hurt like hell after a week? It's details like this that I would like to get right in my stories, so I thought I'd ask around. Thanks in advance!
This is weird, but I guess you've found a primary source on this one. it really depends on the depth of the wound, it would definitely hurt the next day. I was stabbed by a student 6 years ago and I still have pain in the winter like a little old lady! That said, I've worked some rough schools and been stabbed a few times, most of them didn't even scar! a clean stab to the lower arm that's quickly cleaned and stitched would be painful for a couple of weeks and sore to the touch for a month or so. any pressure on the scar would hurt for a lot longer. if your story's set in the summer it's likely to heal better as circulation is also a factor.
It depends on what you cut through and how wide the wound is, and how old you are. Young people heal much faster than older people. For a wider wound: Just the thickness of the skin, after it's stitched up, it won't hurt that much. Cut through muscle, and it's going to need to be immobilized after the muscle and overlying structures are stitched back together. It might hurt a bit when you move around inside the splint. Cut through tendon, same thing, and it might heal more slowly. With either one, it only hurts when you move the muscle or tendon. Bottom line is, if you want medical accuracy a bad wound needs some splinting or a cast otherwise you risk pulling at the edges of muscle and tendon, preventing healing. If it's deep, but not very wide, it just needs to be cleaned up and if the wound isn't gaping, you just bandage it. A hole in a muscle that doesn't sever it probably won't hurt much after a day or so. It is unlikely to interfere with your activities.
how deep was the stab, where specifically on the arm? Back of the upper arm might result in permanent axillary nerve damage, causing loss of arm abduction and an area of numbness along the lateral aspect of the upper arm. Otherwise you can be kind of vague, and the pain might not last longer than a couple months. Source: M.D. student
Wow, this is awesome! Maybe I should just lay down the scenario and see what you guys can make of the type of wound. A university student, relatively young, say 19-20 years old, fights 3 thugs in an alley, blindfolded (I know, not very realistic but it's actually part of the main plot). The third one has a hostage and a knife. It's a visual novel, so the player can make certain decisions, one of which resulting in you attacking the thug after trying to reason with him, but him being just too far away. You sort of throw your left arm in front of you as a defensive reflex and you feel the blade cut into it. So the wound would be somewhere at the lower left arm at the part of the arm that is facing your enemy when you reflexively defend with it. (My English terminology concerning the human anatomy is appearently more limited than I thought...) He got lucky though, so as far as the scenario allows it, it's the "best" kind of wound. Hostage makes use of the situation to knock the thug out. Police arrives shortly after, patches everything up or, if necesary, there is also an ambulance on site. If you say that it needs splinting or that it will at least take months to heal, then that simply means that this choice will have a serious effect on the rest of the story, which is fine and actually kind of cool now that I think about it, but if you think that a wound like this doesn't necesarily have to cut the muscle, then a bandage is more what I had in mind. Thank you for all the great answers, this is really helpful!
You could just have stitches and a bandage, which would really be removed within a manner of a few days (the sutures would be removed in ~week or so). There might be a scar there, but you wouldn't have a bandage there after a month or so if it was really as superficial as it seems you are going for. Splints are done usually to immobilize extremity fractures or joint dislocations or specific types of nerve entrapment, and would not apply in this case.
You would also splint a muscle or tendon if it were severed and repaired, not just bone. For example, Suture Anchor Technique for Muscle Belly Repair: It's the same with a severe sprain, you have to splint the involved joint because you lose stability with the damaged tendon. On the other hand, wounds are easy, just write the wound to fit what the story needs. I would think defensive wounds on a forearm could easily just need sutures and a short healing time. The reader would not be too concerned with such an outcome from defensive knife wounds.
I was referring to a severed muscle or tendon. Now that you clarify the wound a little more, I see no reason such an injury has to sever a muscle.
Awesome, thanks for the update! I guess I'll just keep it sore then for a little while, but not make too much of a deal out of it. Thanks again for the fast and professional replies!
Maybe when the plot goes on and develops over some years then it would be great to still feel it, get the old wounds out and let the character suffer a bit.
I'm in the uk, I worked at what we call Pupil Referral Units-there is a legal obligation to educate students, even if no real school will have them. But it happens in mainstream too. That's why I quit to make sweet FA writing. It's really interesting to see other peoples ideas - based on actual medical knowledge rather than a couple of limited incidents. I loves the internets!
Actually we typically suture lacerated muscles. Strict immobilization can be done but it is not usually advised. I don't understand what I was supposed to get from your link.
I think you are talking about apples while I described oranges. Probably my mistake because I said, "Cut through muscle" when I was referring to severing the muscle completely. If one is only cutting into a muscle as opposed to severing it, the rest of the muscle continues to support the structure so one doesn't need immobilization. I was talking about severed muscles and tendons, not merely lacerations: "You would also splint a muscle or tendon if it were severed and repaired." But I'm not sure what you are referring to saying one doesn't immobilize a severed muscle after repair unless you are merely saying there are differing opinions. Physical inactivity and exercise during skeletal muscle regeneration I agree the immobilization should be for a limited period of time.
I don't know what you are talking about, sorry. You just keep sending these URLs to articles, and I don't know what it is you are trying to say or if you are trying to have some other type of conversation or asking some type of question. The OP asked how to write convalescence from a stab wound to the UE in a realistic manner and I told him that unless there was neurovascular injury, what would most likely happen is that the skin would be sutured, stapled, or glued together and bandaged for a time. If there was some type of nerve injury, the person may experience total sensory and/or motor loss depending on the affected nerve. Depending on the location and wound characteristics, the person might receive oral and/or IV antibiotics. If it was just a glancing blow, which is what it sounds like, then none of these things are likely relevant. "Splinting" is a non-invasive, non-circumferential method of stabilizing fractures and maintaining reductions. What a splint has to do with this conversation is completely lost on me.
I supported my comments. You haven't. Mr med student, I suggest you are completely ignoring my comments and answering as if the OP was clear from the beginning that the injury he inquired about was no more than some defensive wounds. What exactly is it about my posts you are challenging, and on what basis?
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Is there some reason you have a problem addressing the evidence I posted that sometimes you do indeed immobilize muscles and tendons after surgical repair? Because I don't get your problem. I've seen defensive knife wound repairs of the forearm. The extensor muscles and tendons are exposed when you put your forearms out to protect yourself from a knife coming at you. If the knife wound involves transection of the extensor muscles, you immobilize the wrist in extension after the muscle is repaired. Management of Extensor Tendon Injuries How long to immobilize the affected muscles/tendons may be up for debate. You've yet to explain or defend your statement: When someone points out a contradiction to something I've posted, I look into it. If I'm wrong, that's a win, I learn something new. If I wasn't wrong, I say so and support what I said. I'm not trying to insult you. But I don't understand if you're miffed I challenged your statement, if you meant something else by it and I've misunderstood, or if you are just being a jerk. But it's uncalled for.
This thread is extremely helpful! @GingerCoffee , would you mind if I PM you with some questions about stab/slash wounds on particular parts of the body? I see you have quite some knowledge on this subject and it would be awesome if I could get some wisdom from you, but I don't want to take this thread hostage for the OP's sake.
On it! I'll send it tomorrow if I'll have the time, seeing how it's Christmas after all. Thinking about it, merry Christmas
A splint is not synonymous with "immobilization." Of course you immobilize any re-anastomosed tissue.... (common sense).
What nonsense. If you have this much trouble admitting you were wrong in a forum discussion, what does it say about your skills as a future doctor? From my quoted citation above:
