Psychological stress and wound healing in humans: a systematic review and meta-analysis

Article English OPEN
Walburn, Jessica ; Vedhara, Kavita ; Hankins, Matthew ; Rixon, Lorna ; Weinman, John (2009)

Objective: The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing. \ud Methods: A systematic search strategy was conducted using electronic databases to search for published articles up to the end of October 2007. The reference lists of retrieved articles were inspected for further studies and citation searches were conducted. In addition, a meta-analysis of a subset of studies was conducted to provide a quantitative estimation of the influence of stress on wound healing. Results: Twenty-two papers met the inclusion criteria of the systematic review and a subsample of 11 was included in a meta-analysis. The studies assessed the impact of stress on the healing of a variety of wound types in different contexts, including acute and chronic clinical wounds, experimentally created punch biopsy and blister wounds, and minor damage to the skin caused by tape stripping. Seventeen studies in the systematic review reported that stress was associated with impaired healing or dysregulation of a biomarker related to wound healing. The relationship between stress and wound healing estimated by the meta-analysis was r=−0.42 (95% CI=−0.51 to −0.32) (P<.01). \ud Conclusion: Attention now needs to be directed towards investigating potential moderators of the relationship, mediating mechanisms underpinning the association, as well as the demonstration of a causal link by the development of experimental interventions in healthy populations.
  • References (81)
    81 references, page 1 of 9

    [1] Rozanski A, Blumenthal JA, Davidson JW, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice. J Am Coll Cardiol 2005;45:637-51.

    [2] Mitsonis CI, Zervas IM, Mitropoulos PA, Dimopoulos NP, Soldatos CR, Potagas CM, Sfagos CA. The impact of stressful life events on risk of relapse in women with multiple sclerosis: A prospective study. Eur Psychiatry 2008;23:497-504.

    [3] Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol 2008;5:466-75.

    [4] Segerstrom SC, Miller GE. Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychol Bull 2004;130:601-30.

    [5] Robinson FP, Mathews HL, Witek-Janusek L. Issues in the design and implementation of psychoneuroimmunology research. Biol Res Nurs 2002;3:165-75.

    [6] Vedhara K, Fox J, Wang E. The measurement of stress-related immune dysfunction in psychoneuroimmunology. Neurosci Biobehav Rev 1999;23:699-715.

    [7] Glaser R, Kiecolt-Glaser J. Stress-induced immune dysfunction: implications for health. Nat Rev Immunol 2005;5:243-51.

    [8] Blecken SR, Villavicencio JL, Kao TC. Comparison of elastic versus nonelastic compression in bilateral venous leg ulcers: a randomized trial. J Vasc Surg 2005;42:1150-5.

    [9] Chung J, Bartelson BB, Hiatt WR, Peyton BD, McLafferty RB, Hopley CW, Salter KD, Nehler MR. Wound healing and functional outcomes after infrainguinal bypass with reversed saphenous vein for critical limb ischemia. J Vasc Surg 2006;43:1183-90.

    [10] Kantor J, Margolis DJ. A multi-centre study of percentage change in venous leg ulcer area as a prognostic index of healing at 24 weeks. Br J Dermatol 2000;142:960-4.

  • Metrics
    0
    views in OpenAIRE
    0
    views in local repository
    718
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    Sussex Research Online - IRUS-UK 0 718
Share - Bookmark