Comment: Stress (including the stress of relationship disharmony) can impede wound healing.

Immunol Allergy Clin North Am.

2011 Feb; 31(1): 81–93.

doi: 10.1016/j.iac.2010.09.010

Jean-PhilippeGouinMAabJanice K.Kiecolt-GlaserPhDabc

Synopsis

Converging and replicated evidence indicate that psychological stress can modulate wound healing processes. This article reviews the methods and findings of experimental models of wound healing. Psychological stress can have a substantial and clinically relevant impact on wound repair. Physiological stress responses can directly influence wound healing processes. Furthermore, psychological stress can indirectly modulate the repair process by promoting the adoption of health-damaging behaviors. Translational work is needed to develop innovative treatments able to attenuate stress-induced delays in wound healing.

Keywords: wound healing, stress, cytokine, cortisol, psychoneuroimmunology, oxytocin

Wound healing is a critical process involved in the recovery from injury and surgical procedures. Poor healing increases the risk for wound infections or complications, lengthens hospital stays, magnifies patient discomfort, and slows return to activities of daily living. Converging evidence from different research paradigms suggest that psychological stress and other behavioral factors can affect wound healing. A meta-analytic study using diverse wound healing models and outcomes found that across studies there was an average correlation of −.42 between psychological stress and wound healing []. This suggests that the relationship between stress and wound repair is not only statistically significant, but also clinically relevant. This review presents data and methods from observational, experimental, and interventional studies corroborating the impact of stress on wound healing. Potential behavioral and physiological mechanisms explaining the association between stress and impaired wound healing are also discussed.