Psychological Stress and Wound Healing in Humans

What We Know

Valentina S. Lucas, RN, MS, ANP-BC

Disclosures

Wounds. 2011;22(4):76-83. 

In This Article

Stress and Wound Healing

It is well established that psychological stress modulates immune system functioning and a fully functioning immune system is integral to timely and effective wound healing. Numerous studies have explored the relationship between psychological stress and wound healing. Although both human and murine models have been utilized in studying stress and wound healing, only studies involving human subjects will be included here. For inclusion in this review, all studies had to have at least one measure of stress, such as the Perceived Stress Scale (PSS). Studies exploring the relationship between other psychological factors, such as depression or anxiety, were not included in this review.

Systemic factors known to have negative effect on wound healing were considered exclusion criteria and were similar across all studies. Exclusion criteria most commonly cited included tobacco use, diabetes, peripheral vascular disease (PVD), cardiovascular disease (CVD), difficulty with wound healing in the past, immunologically related problems, recent surgeries, previous psychiatric illnesses, and use of anti-inflammatory medications with obvious immunological effects. Smokers and individuals with frequent alcohol consumption were often excluded. Wound types consisted of experimentally created wounds (eg, punch biopsy, blister) or preexisting clinical wounds (surgical and leg ulcers). Research utilized a variety of measures to evaluate the relationship between psychological stresses and wound healing. This makes a comparison of studies somewhat difficult since outcome measures varied. For the purpose of this review, findings are grouped based on how healing was assessed.

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