One third-party campaign setting I had a campaign in had a mechanic whereby if you reached -8 or lower in bleedout, you would gain a lasting wound, which had a penalty associated with it, and a cure spell or heal DC needed to rectify it.
Death had a chance on raise or resurrect to clear it them: 25% chance for Raise, 50% for Resurrect. True Ressurection always brings the person back whole (at significant costs).
The possible maluses were:
I don't neccesarialy agree with some of the actual examples here, which I'm just reproducing from this campaign setting, but it gives a starting point for the kind of thing we mean. I'm sure we can collectively come up with some more interesting maluses.Concussion, Int -1, Heal 20 or Lesser Restoration
Damaged eyes, Spot -10, heal 25 or Remove Blindness/Deafness
Tinnitus, Listen -10, heal 25 or Remove Blindness/Deafness
Broken Arm, AB -5, heal 30 or Restoration
Broken Leg, Movement speed halved, heal 30 or Restoration
Broken Back, Carry weight halved, heal 40 or Heal
Shattered Constitution, Con -3, heal 50 or Greater Restoration
As far as implementing them, I would create a d% table when we agree on specific wounds, and have it roll versus that. if you roll the same thing twice, I would consider that the second wound is discarded. Lucky you, you got a freebie.
Wounds in this setting were rolled versus a Fort DC 25 at -8 at bleedout, and then rolled on a D% 25 or 50 chance when raised. They were not restored if you were merely healed to stabilize and recover you.