PSYCHOLOGICAL STRESS CAN SLOW THE RATE OF WOUND HEALING
COLUMBUS, Ohio -- A new study that looked at women who care for chronic patients is showing that psychological stress can slow the healing of wounds by as much as nine days.
The findings by Ohio State University researchers, although preliminary, could be important in improving the recovery of patients following surgery and lessening the chances of developing some post-surgical infections.
Janice Kiecolt-Glaser, professor of psychiatry and psychology; Phillip Marucha, assistant professor of periodontology and microbiology & immunology; Ronald Glaser, professor of microbiology & immunology and internal medicine; and William Malarkey, professor of internal medicine, microbiology & immunology, and biochemistry, reported on the work in a paper published this week in the British medical journal The Lancet.
The research team compared how well skin wounds healed in a group of more than two dozen older women. Half of the women werethe principal caregivers for relatives who were demented. Theremaining women served as a control group for the study.
All of the women were asked to complete a questionnaire which rated how stressed they considered their daily lives. A sample of blood was also taken from each woman at the beginning of the study and analyzed to determined the levels of Interleukin-1, an important cytokine involved in immunity.
A punch biopsy, or small skin wound about the size of a pencil eraser, was made in the forearm of each study participant under local anesthesia at the University's Clinical Research Center. The wound was then cleaned and re-bandaged every day for the first week. After that, the women were asked to return to the CRC every three to four days so that their wounds could be cleaned and photographed to provide a record of healing.
During each visit, the women's wounds were also cleaned with hydrogen peroxide and researchers noted how much the peroxide foamed during the cleaning. The foaming occurs when the hydrogen peroxide reacts with an enzyme, catalase, that's present in damaged tissue. The wound was considered healed with it no longer foamed from the hydrogen peroxide.
At the end of the study, the caregivers' wounds took an average of nine days, or 24 percent, longer to heal than did those of the women in the control group. The blood analysis also showed that the caregivers produced less Interleukin-1 than did the women in the control group. The study also showed that the changes in the rate of wound healing among the stressed women were most apparent in the first two weeks after injury.
"That's very important," explained Kiecolt-Glaser. "If a patient is going to get infections or other problems following surgery, that two-week period is when you'd expect the worst to occur."
Marucha said that this stress-related impact on healing could be important in other ways as well.
"If you've just had surgery to remove a tumor and are waiting for the results of a biopsy, the amount of time it takes to get the results may be very critical in terms of the early phases of wound healing" since surgery patients might benefit from some counseling to reduce stress anxiety before the surgery. They also might benefit from getting the results of biopsies much quicker.
The researchers are cautious about pushing these findings too far since the study provided only limited data.
"We don't know if the traditional types of behavioral intervention such as counseling would have any effect on wound healing, or if antidepressant drugs would have a positive effect," he said.
"We simply haven't tested for those types of factors yet," Kiecolt-Glaser said.
Anna Mercado, a graduate student in dentistry, participated in the study. The research was supported in part by the National Institute of Mental Health.
Contact: Janice Kiecolt-Glaser, (614) 293-5120; Kiecolt-Glaser.firstname.lastname@example.org
Phillip Marucha, (614) 292-1162; Marucha.email@example.com
Ronald Glaser, (614) 292-5526; Glaser.firstname.lastname@example.org
William Malarkey, (614) 293-8775
Written by Earle Holland; Holland.email@example.com
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