October 8th, 2014

Would skin heal first: Wound healing after perforating stab wound?

Hi all,

So my setting is late 14th century Japan, and this a medical question related to wound healing in a specific case. It's plot-important for a number of characters, so I don't want to just make things up when I can be accurate. I also plan on asking my Anatomy professor next class.

My main question is this: In the case of a stab wound that perforates a major organ, all other factors being equal and without access to modern medical care, which is likely to heal faster: the skin or the organ itself? Given what I know about wound healing, I'm pretty sure that the skin would heal first, and that the organ would take longer to repair itself.


In the scenario I'm working on, the character is stabbed with a spear and her stomach is perforated. She recieves very basic medical treatment within several hours.

Search terms include: "Acute wound healing", "organ damage," "wound healing process," and "complications of stab wounds".

Thanks for your help.

- CreativitySpren


EDIT: Taking infection and the points raised so far on the damage fluid in the abdominal cavity would cause, I did some cross-checking and in-depth reading on gastroenterologic surgical procedures for fluid draining, penetrating trauma of an abdominal wound as seen in trauma centers, and gastrointestinal perforations (I went right for resources meant for physicians). Stupid of me to have completely missed that aspect. In the scenario as I have it set up now, the perforation of her stomach wall would lead to secondary peritonitis and likely death. I've looked up what can be done to drain the area and treat the infection, but my characters obviously wouldn't have access to modern medical equipment, antibiotics, or anything approaching medical expertise. This includes by the standards of their time; however, the subgroup with which the character lives is as a whole relatively adept at treating general and some severe combat injuries and the associated complications as a result of being a martial society that deals with such things on a regular basis. They wouldn't know to drain it, I don't think, and even if they did figure that out, I can't see a realistic way for them to drain it (as much as it would need to be) without Medicina ex Machina making an unwanted appearance. In short, I've killed her if I keep it as it is.

As the main character, that would take a wrecking ball to the rest of the plot. So, that said, I would like to keep the basic idea of the character being significantly injured/attacked, essentially ignoring a serious secondary injury in an attempt to negate the psychological reality of the initial event and return her life to normal, and nearly dying as a result. What I'm trying to demonstrate in terms of story here is that the character is refusing to confront the real problems she's facing, on all levels, and even more importantly, that it's really not working out all that well for her. The outcome is, essentially, her lifelong poor coping strategies waltzing up and putting a gun to her head. It's caught up with her before, but she can't run away this time.

I clearly need to modify the injury. Is there any way organs can still be involved, without killing her? 

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