Wounds and Stress
When we are talking about wound healing, we are talking about the process of recovery from injury and surgical procedures. The slower the healing process the more there is a risk of increasing wound infections or complications, it also makes for longer hospital stays, intensifies patient discomfort, and slows the patient’s return to activities of everyday life. From many different research studies the evidence is building that psychological stress and other behavioral factors can affect wound healing.
I have read of several studies using different types of wounds’ healing and outcomes. They seem to agree that there is a quantifiable correlation between psychological stress and wound healing. This would tend to suggests that the relationship between stress and wound recovery is not only a matter of statistical interest, but it also has a practical clinical relevance.
The data and methods from observational, experimental, and interventional studies reaffirm stress’ impact on wound healing.
Studies which examine wound and healing involved complications after surgeries provide evidence regarding the impact of stress on wound healing. Greater fear or distress before surgery has been linked to less positive outcomes including longer hospital time, more complications after the surgery, and higher rates of complications that required a return to the hospital.
For example, one study followed 111 patients having gallstone surgery. Those who reported having more stress on the third day after the procedure had a longer hospital visit, that is when compared to less anxious individuals. Another study used 309 patients who underwent an elective heart bypass surgery. The patients who were more optimistic ended up being less likely to be rehospitalized than the pessimistic people.
On the other hand, the patients who had more depressive like symptoms proved more likely to require hospitalization later for infection related complications from the surgery than individuals reporting less distress.
This finding was duplicated in another study including 72 patients undergoing bypass surgery. In that study the patients who had more stress/depression symptoms when discharged develpoed more infections and poorer wound healing over the following 6 weeks after surgery. That is when you compare them to others who reported less distress.
Psychological issues can also modulate chronic wound healing. There was a study with fifty-three older adults with chronic lower leg wounds. After they were followed to assess speed of healing, patients who had the highest depression/anxiety levels were found to have a 4 times more likelihood to have a delayed healing, compared to individuals who reported less distress. Surprisingly, in these studies, distress predicted consistently healing outcomes better than differences in sociodemographic context and medical status.
Psychological distress, a form of stress, clearly appears to be a major influence in recovery from medical procedures and chronic wound healing.