I really love this piece. I've seen photos of scars / stitches before but the way you've done it here creates a strong mood for the viewer. The expression on her face does express pain but what comes through more is a feeling of newfound strength mixed with grim determination. The gritty darkness of this piece does help the viewer into her world of pain while strangely at the same time, the pose of the model (with her back to us to show the wound but she's not looking at the viewer) shows us that while we can sympathize with her pain, she is alone in her dealing with it. Her eyes being open, staring off to the left, show that she's not going to close her eyes and wish this away, but will deal with it the best she can. Her pose seems to indicate that while she knows she can gain support through empathy by showing us this horror, she's doing so a bit reluctantly, as if she is aware this is something that she understands is hers to deal with, bitter as it is.
I find myself wishing I could see her face and wound a bit clearer; perhaps it's a hint too dark, a hint too gritty, covering the model just a touch too much BUT that being said, the dark and rough feel is what helps heighten the viewer's sense of the darkness being felt by this subject. Maybe it's good that I want to see her more... maybe it's drawing me in and making me more sympathetic to her plight. Brilliantly done as always.