If you were completely skinned, would it still hurt?

Factual Questions
1

So last night I watched Silent Hill, the movie version of a popular horror video game series. It was creepy as hell and I enjoyed it, but one part especially horrified me. (The part below isn’t really a spoiler, but I’ll put it in a spoiler box just in case there are people who haven’t seen this movie and still care about not knowing the details.)

Just as the protagonists (Rose and Cybil) are racing with a local girl (Anna) for sanctuary in the church because the Nightmare World change is racing toward them, Anna gets distracted on the church steps. Pyramid Head (a big demon/monster) rises up from nothing behind her and picks her up by the throat. With no effort at all he rips Anna’s clothes off in one quick motion. Then, as the protagonists watch in horror from the doorway of the church, he grabs the skin on Anna’s chest, which is astonishingly pliable, and tears off all of her skin in one piece with the same quick motion. Rose and Cybil duck into the church and shut the doors as he flings the bloody skin at the doors, splattering them with blood as the doors finish slamming shut.

So after seeing that, I started wondering: if that actually happened to somebody, how much pain would they be in once the entire skin is off?

As far as I know, most of your nerve endings are in your skin, so once the actual skin is gone, the only connection to your brain from all the nerves that used to be in the skin is the broken nerve endings that lead into the spinal cord. Are those still firing so you’d be feeling pain everywhere there used to be skin? Or would you be numb? I know they say full-thickness burns don’t hurt because the nerves are destroyed, but I don’t know if that situation really applies here, since those nerves are destroyed by heat and in this case the nerves would be torn.

And are there nerves in your muscles and fat and whatever else is under your skin so that you’d be feeling extreme pain from them being exposed to the air, feeling your weight on them, etc.?

And assuming you got no medical care (I’m assuming Pyramid Head, or a rea-life psychopath who would remove all of your skin, wouldn’t take you to the doctor after it was done) would blood loss kill you quickly in a situation like that, or could you live for hours or days before dying?

This thread is sort of related (and I even posted to it!), but it doesn’t really answer my current questions.

2

My WAG is that if you are not experiencing a lot of pain in such a case it is because you are dead. Have you never picked at a deep wound? Err, on second thought I might be the only weirdo that pokes his own arm meat with a knife, but no, it’s turtles all the way down, i.e. perhaps most nerve endings are in the skin but those are probably including tactile sensation nerves as well. If most the endings are in the skin I don’t think the rest of the nerve necessarily gets removed with the skin either, and a damaged nerve is a lot worse than a functioning one to a point.

3

I have no extensive medical training, but I can relate what happened to me. In the early 70’s I was a front seat passenger in an auto accident. I have no memory of the events of the actual accident but, as I understand it, I was thrown forward through the windshield while, at the same time, the engine was pushed back into the passenger compartment. As a result the flesh was torn from the front of my left leg, among other injuries. The accident occurred in the late night/early morning and, even though I was in the military in an area of a large military hospital, I was taken to a civilian hospital. I was fortunate in that a local plastic surgeon happened to be present when I was brought in. He did a great job of repairing the lacerations in my face, but there was little he could do about my leg. Several days later I signed myself out against the medical advice of that same doctor. A few days after that I found myself in extreme pain and I called that doctor who agreed to meet me at the local ER to treat me. At that time he debrided (removed the dead flesh) the wound. This was painful to the point that I lost control of my bladder while he was working. He informed me that I needed to check into the nearby military hospital for further treatment. I was still convinced that I could heal myself, so I ignored his advice. A couple of days later, again in pain, I took his advice. After my admittance, to the military hospital, it was discovered that I had a staph infection, which required isolation and very aggressive antibiotic treatment. They even had a psychiatrist visit me to advise me that, if the infection couldn’t be stopped, I would llikely need to have my leg amputated. Fortunately they were able to defeat the staph, but not before I had a reaction to the aggressive use of antibiotics. Next came a skin graft. The skin was removed fom inside my left thigh and transplanted to the injured area of my left shin. When I was taken back to my room, I was provided w/ a tentlike apparatus designed to keep the bedcovers from touching my legs. That night, I must have misunderstood the instructions, I got up to visit the bathroom (it was a private room). The next morning my doc. came in to examine his work and he was furious at what he found. By getting up I had disrupted the contact between the skin graft and my leg and caused fluid “bubbles” to form. He had to incise each bubble and try to reestablish contact for the healing to be successful. During this period I, not only, had the skin graft to deal with, but the area on my inner thigh where they removed the donor skin. On one ocassion the bedcovers managed to slip through the tent frame and contact the exposed area, again I lost control of my bladder, it was totally involuntary.
Several years later I worked in a hospital that had a well respected burn unit. This reinforced my awareness of the seriousness of skin damage. The loss of the epidermis not only exposes nerve ending, but leaves one unprotected from infection.

4

You ever read something, then wish you hadn’t!

Seriously, I guess you recovered from all that…but that is one hell of a story!

5

Sorry, guess I should have included a “TMI”. It was almost 35 years ago and things turned out fine. Don’t drink and drive and don’t drink and ride w/ someone who drives drunk.

6

Whoa . . . whoa. That was horrifying!

7

If there was ever a need for a vomit smilie…

8

Thanks A.R. (A.R. also recounts his[sup]1[/sup] story in the thread I linked to with some other details, too. Or if it wasn’t that thread, it was one of the six that came up when I searched for skinned alive pain). My sympathies on your horrific experience. But I think what you went through is a little different than what I’m thinking of – after all, you still had skin surrounding your injury, right? Which presumably had portions of the nerves from the lost area of skin still running through it?

(Hmmm. Or would it? Do nerves that terminate in the upper layers of skin run through the skin to get to the spine, or do they burrow through the inside of the body?)

If you don’t mind a somewhat personal question, how did the skin graft end up? Do you have sensation in the area that was grafted? I have a scar on the base of my left thumb from a sharp edge of computer case that left a significant portion of the thumb permanently numbed and tingly, but not completely numb. Is it something like that?

Of course, I certainly wouldn’t blame you if you don’t want to talk about it.

What about removal of not just the epidermis, but the dermis and the subdermis too? They don’t do that when doing a skin graft, I believe – they just remove enough live skin so that it will regrow over the lost area, while leaving enough live skin remaining so the donor site will regrow too. But what if the skin was completely gone?

(BTW, I’m not asking these things of you specifically. They’re just general questions.)

[sup]1[/sup]Sorry if my assumption that you’re male is wrong, but for some reason that’s how I think of you.

9

I had forgotten that earlier post, but it refers to the same incident. I can’t respond to your questions about where, specifically, the nerve ending reside, I only know the sensation that I experienced. The more dmage to the epidermis, the more you’ll feel the raw pain, but I think the more important issue is the exposure to infection. That’s the biggest threat to buern patients. The pain can be dealt w/. at least to a certain extent, but infection is very difficult to treat in these cases.

35+ years later I have a scar on my leg about 10 incheces long and 3-4 inches wide. There is feeling on the scar surface, but it’s much less sensitive than the surrounding skin and, of course, there’s no hair growth on the scar tissue. I really don’t think about it unless the subject comes up. If I were a woman, I might have to wear some heavy nylons w/ a skirt, but since I’m not, it isn’t an issue. I wear shorts in summer and I’ve never noticed anyone staring.

10

Yeah, clearly if you actually had all your skin removed, you wouldn’t survive long – if shock and/or blood loss didn’t kill you within hours, you’d surely contract a raging infection that would do it within days. (I just remembered that Scott Smith’s new book The Ruins involves a character who flays himself nearly to death, but that’s neither here nor there.) I’m just wondering how much (or if) it would hurt if all your skin was gone.

OK, good to know that I wasn’t wrong about you being a man rather than a woman. :wink:

Frankly, I’m surprised that there’s any sensation at all on a skin graft. The nerves must to a lot of regrowing and reattaching. (Unless there were still nerves there or something. Which I guess is part of my question: are pain-sensing nerves limited to the skin itself, or are there nerve endings under the skin too, in the muscle and fat and whatnot?)

(And again, these are just general questions I’m asking of everybody, not you specifically.)

11

Titian’s The Flaying of Marsyas (based on this Greek legend).

12

You’re going to have to attract a medico type to comment on how deep nerve endings go, that’s beyond my scope. I do, vividly, remember the pain on my leg, before I finally realized that I wasn’t invincible and decided to go back into the hospital for treatment. :o