The phrase "twist knife in wound" is a powerful and evocative expression of causing additional pain and distress to someone who is already hurting. There are a number of synonymous phrases that carry the same connotation. "Pour salt in the wound" is a common one, indicating a deliberate and vindictive act of exacerbating someone's distress. "Rub salt in the wound" is similar but more physical, suggesting a rough or abrasive action. Other phrases that capture the emotional impact of "twisting the knife" include "adding insult to injury," "making matters worse," and "kicking someone when they're down." All of these expressions reflect the depth of cruelty and unkindness that can arise in human interactions.