Recovering from facial lacerations

[ohnoesitstori]

So, my story takes place in a yet to be determined modern American city, and basically the main character ends up with a cut starting at the corner of his mouth and going about 2 inches across his cheek. It's done with a box-cutter in unhygienic conditions, and it will be several hours before he can get treatment for it. (Maybe longer? I'm not sure

Comments

[alassenya]

He'll be able to talk throughout, though his speech will obviously be distorted until his cheek is repaired, and labial consonants (p, b, m) may be very difficult for him). While the stitches are in he will obviously have to take care to speak without moving his lips too much, to avoid ripping the flesh. Drinking will be more comfortable than eating, at least for the first 48 hrs, and he won't really be able to clean his teeth properly on the affected side so salt water rinses are probably his best option (mouthwashes might work but most contain alcohol so not only would they hurt but they would impair the healing process).

Any qualified doctor should be able to do a reasonable job of stitching it up as long as they have access to antiseptics and 5/0 or 6/0 nylon or prolene suture material. Suturing is best done within 6 hours, but if the wound is relatively neat (as it would be in this case) and can be cleaned out adequately, he's probably OK up to 12 hours. Faces heal fast, so stitches will only stay in for 4-6 days depending on various factors such as age, inflammation, nutritional status ... the younger and healthier your patient, the shorter the length of time. If the doctor is concerned about the strength of the wound he might take out half the stitches and leave the rest another day or two. Steristrips would help to minimise tension on the wound after that. Sutures on the inside of the cheek can be left for longer as insurance because the scars won't be visible. Scarring on the cheek will always be visible, but might not be obvious and definitely shouldn't be "hideous" unless infection develops.

[ohnoesitstori]

Thanks!
Hmm, so if I want a highly visible scar, I might want to complicate things a bit. I have heard that some people put two blades together with a matchstick in between, so that it's harder to stitch up cleanly. Would that make a significant impact on healing time, do you think?

[alassenya]

Oh I'm sorry, I didn't pick up that you actually wanted a visible scar. If that's the case, your attacker needs to use something that will create a very jagged wound that can't be stitched up easily - a coarse hacksaw or straight saw blade would be good (or one of those really cheap and coarse serrated steak knives you get in the supermarket). A really dirty blade/wound or a delay of 18hrs or more in getting medical care would also be useful, because then the wound is contaminated and can only be held loosely together rather than stitched closely, so that no anaerobic pockets are created, and that will create a wider and more prominent scar. If your attacker is using broken glass then you might get a double cut which actually removes some tissue (not your parallel line cut as above, that wouldn't remove enough tissue) - you really want to lose a chunk so that the skinfolds don't line up - that will give you a really nasty puckered scar. Depending on the size and amount of distortion to the cheek tissue, your victim may also end up with a slight change in speech, and in the worst case may have difficulty getting a proper seal with the lips, which would create a sore area at the corner (angular cheilitis or angular stomatitis).

I hope that helps.