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


Clearly, there are substantial data in human studies to suggest that psychological stress and the subsequent effect on immune system disruption can impact wound healing. The purpose of this article is to serve as a foundation and a review of the existing literature on the relationship of psychological stress and wound healing in humans. Additionally, a review of available tools to measure wound healing for nursing research was presented. This article provides but a glimpse of what is known and what is still left to be discovered in the exciting area of psychological stress and wound healing. Other psychological mediators, such as depression and anxiety, have been shown to slow wound healing[47–49] and should be explored further. Psychological stress can lead to unhealthy behaviors which may impact wound healing such as smoking,[50] poor nutrition,[51] and altered sleep.[52] For example, Rose et al[52] point out that stress can negatively impact sleep, leading to disturbed sleep patterns and a reduction in growth hormones, which may down-regulate the tissue repair response.

Although numerous factors play a role in whether or not a wound heals, such as nutrition, underlying health conditions and appropriate care, it is clear that cytokines play a crucial role as well. If dysregulation of the various cytokines occurs, a potential disruption of normal wound healing results, leading to delayed healing and increased risk of infection and wound complications. Future work to examine the exact mechanisms of pro-inflammatory and anti-inflammatory cytokines will shed additional light on the mechanisms of stress on wound healing. Examination of wound fluid holds the potential to identify biomarkers of wound healing and subsequently provide diagnostic information on the wound environment to improve treatment modalities.


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