Psychological Stress and Wound Healing in Humans

What We Know

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


Wounds. 2011;22(4):76-83. 

In This Article

High Resolution Ultrasound

Ultrasounds use sound waves to produce images of soft tissue anatomy. Basically, a probe is placed over the area of interest and transmits sound waves into the body. When these sound waves hit a boundary between acoustically different tissues, such as bone versus soft tissue, a proportion of the energy, known as an echo, is reflected back.[33] High-resolution ultrasound typically involves frequencies of 15 megahertz (MHz) or higher. Depth of penetration is lost with higher frequencies, but resolution is improved. High-resolution ultrasound is useful in that it can show the fluid content of various tissues. Greater fluid content results in a decrease in the echogenicity in the tissue being observed. The use of high-resolution ultrasound has been shown to be effective in assessing dermal wounds.[34–36]

Ebrecht et al[17] used a prospective, longitudinal, observational design to examine the relationship between perceived life stress and impaired wound healing. Psychometric testing included the PSS, the General Health Questionnaire, and the UCLA Loneliness scale. Four 4-mm punch biopsy wounds were placed on the upper arm of nonsmoking males, and wound healing was evaluated using high-resolution ultrasound. A significant negative correlation between speed of wound healing and both the PSS scores (r = −0.59; P < 0.01) and the General Health Questionnaire was found. Morning cortisol levels were highest in those individual whose wounds were the slowest to heal.

Weinman et al[37] utilized high-resolution ultrasound in evaluating the healing of wounds placed on the hard pallet. A prospective, longitudinal design with random assignment was used to test the ability of a disclosure intervention to lower psychological stress associated with a traumatic experience and to improve healing. While the disclosure intervention did not have a significant effect on the PSS scores, participants who wrote about emotional experiences had significantly faster wound healing times (wounds ~11% smaller) than the control group.


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