My group wants long-term wounds

[Doctor Futurity]

Actually, I think the effect of a throat-slitting could be handled in the RAW by treating it somewhat like a disease or poison, maybe. An example:

Slit Throat
(Conditional to an attack that targets the location in question and is successful, perhaps delivering enough damage to bloody the target)
Attack: situation dependent (see above), but must be initiated with a slashing/piercing weapon.
Endurance: Improve DC 15+1/2 attacker's level; Maintain DC 13+1/2 attacker's level; Worsen SC 10+1/2 attacker's level (maybe 2/3 level for all these if the attacker is an assassin class?)
Initial Effect: The target loses three healing surges and can not speak with more than a harsh whisper. Target takes 5+1/2 attacker's level ongoing bleeding damage (save ends).
Worsens: target is unable to speak and loses all healing surges; can't regain surges until it improves.
Final State: the target dies from infection.
Improves past Initial Effect: target recovers all healing surges and can speak again.

In fact, it just occured to me that the disease track can be used to pretty much simulate any lethal wound you want:

Lethal Blow
Attack: variable; attack reduces target to 0 hit points and target fails its first mortality check (this could vary)
Endurance Check: Improve DC 15+1/2 attacker's level; Maintain DC 13+1/2 attacker's level; Worsen SC 10+1/2 attacker's level (alternatively, DC could be based on Page 42 if the DM doesn't want to keep track of attacker levels here)
Initial Effect: target is badly injured; grants combat advantage, and is prone. Target will go prone if it moves more than 3 squares per turn (at the end of the move). Target loses all healing surges.
Improves: target regains all healing surges after it's next extended rest.
Worsens: Target loses all healing surges and suffers from fevers and delerium; target is now semi-conscious, treated as stunned until improving or worsening.
Final Effect: target dies due to severe injuries.

Anyway, it's an interesting (and easy) idea to implement. I make the threshold failure of the first mortality check after 0 HP so a character who "hangs on there" can possibly get regular healing and treatment....but it would make for some gritty crippling wounds, I imagine. It might be a bit unfair to those characters who are not trained in Endurance, though....so much for them!

 

[jstomel]

The rule I use, purely for flavor, is that if you get bloodied in a fight then you have picked up a scar or a bruise or a broken nose or something that bothers you for a few days (no penalty associated). If you get dropped then you have picked up a serious wound, something that has to be sutured or cauterized or set or a major sprain or torn ligament. I make the player come up with a description of the long term and lingering effects of the injury. I don't introduce any penalties for them, but I am always sure to emphasize the next day that even though they may be at full hitpoints they still ache and limp and feel like they have been through the wringer. I'll trot out old injuries as flavor text some times, like "The blast of cold air makes your scar ache where that orc slashed your belly open."

 

[Garthanos]

The rule I use, purely for flavor, is that if you get bloodied in a fight then you have picked up a scar or a bruise or a broken nose or something that bothers you for a few days (no penalty associated). If you get dropped then you have picked up a serious wound, something that has to be sutured or cauterized or set or a major sprain or torn ligament. I make the player come up with a description of the long term and lingering effects of the injury. I don't introduce any penalties for them, but I am always sure to emphasize the next day that even though they may be at full hitpoints they still ache and limp and feel like they have been through the wringer. I'll trot out old injuries as flavor text some times, like "The blast of cold air makes your scar ache where that orc slashed your belly open."

I like that... I like long term wounds ... but my players... umm not so sure.
My favorite wound system is opt in...

http://www.enworld.org/forum/4e-fan-creations-house-rules/240891-wound-system-2.html

An element from that system that I like even if I wasnt going quite so cinematic... would be the idea of "aggrevating a wound" ...basically its a recurring impairment (like slowed save ends for a leg injury) that occurs on a critically bad roll during battle..

An element that I like is the idea that taking a critical might give a wound but also allows a jolt of temporary hit points.

 

[Tharizdun]

I think you can do better.
maybe you should make em regret their wishes. so a throat was cut. The PC has only 3/4th his hp left and only 3/4th his healing surges for 2 weeks, despite magical healing. Furthermore, cut his movement by 1/4th, or else he automatically becomes bloodied.

I think in a game with magic anything can happen. the magic speeds up the natural healing of a PC so recovering from a normally fatal wound seems weird. But hey, it's magic. ANd when a PC is incapacitated, that player's fun is gone. That is the main lesson they should learn. A cut to the throat is merely a flesh wound. ;-)