Can Medical Hypnosis Accelerate Post-Surgical Wound Healing? Results of a Clinical Trial

Abstract

Although medical hypnosis has a long history of myriad functional applications (pain reduction, procedural preparation etc.), it has been little tested for site-specific effects on physical healing per se. In this randomized controlled trial, we compared the relative efficacy of an adjunctive hypnotic intervention, supportive attention, and usual care only on early post-surgical wound healing. Eighteen healthy women presenting consecutively for medically recommended reduction mammaplasty at an ambulatory surgery practice underwent the same surgical protocol and postoperative care following preoperative randomization (n = 6 each) to one of the three treatment conditions: usual care, 8 adjunctive supportive attention sessions, or 8 adjunctive hypnosis sessions targeting accelerated wound healing. The primary outcome data of interest were objective, observational measures of incision healing made at 1,7 weeks postoperatively by medical staff blind to the participants' group assignments. Data included clinical exams and digitized photographs that were scored using a wound assessment inventory (WAI). Secondary outcome measures included the participants' subjectively rated pain, perceived incision healing (VAS Scales), and baseline and post-surgical functional health status (SF-36). Analysis of variance showed the hypnosis group's objectively observed wound healing to be significantly greater than the other two groups', p < .001, through 7 postoperative weeks; standard care controls showed the smallest degree of healing. In addition, at both the 1 and 7 week post-surgical observation intervals, one-way analyses showed the hypnosis group to be significantly more healed than the usual care controls, p < 0.02. The mean scores of the subjective assessments of postoperative pain, incision healing and functional recovery trended similarly. Results of this preliminary trial indicate that use of a targeted hypnotic intervention can accelerate postoperative wound healing and suggest that further tests of using hypnosis to augment physical healing are warranted.

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

“…Inspection of the retrieved articles resulted in 145 being excluded as the papers did not contain empirical data (88 studies), did not measure stress as the independent variable (11 studies), assessed other indices of "recovery" rather than specific measures of wound healing (25 studies), measured healing in a condition excluded from this review (gastric ulcer or skin complaint) (15 studies), or used animal models (six studies). A further eight studies which looked at the impact of complimentary therapies such as hypnosis [56] or therapeutic touch [57] on wound healing were excluded as either stress or healing was not measured. The remaining 23 studies included data which investigated the relationship between stress and wound healing.…”

The Role of Patients’ Response Expectancies in Side Effect Development and Control

“…148 In 2003, researchers conducted an interesting study that showed adjunctive hypnosis contributed to a significant increase in the rate of postsurgical, site-specific healing. 149 In a series of experiments, Ikemi and Nakagawa showed that it was possible to inhibit the normal dermatological response from contact with poisonous leaves by means of hypnosis and that it was also possible to cause dermatitis from nonpoisonous leaves by suggestion. 150 Interventions involving suggestion have been shown to reduce blood loss during elective spinal surgery, 24 to have a positive influence on postoperative gastrointestinal motility in patients undergoing abdominal surgery 21 and to be a clinically effective treatment for the elimination of viral-caused warts.…”

Neurophysiology of pain and hypnosis for chronic pain

“…These studies have concluded that hypnosis can impact pain by affecting a number of different neurophysiological processes that make up the pain matrix, rather than by influencing a single mechanism or process. Specifically, research indicates that hypnosis can impact activity in: (1) the periphery and spinal cord [67][68][69], (2) the thalamus [65,70,71], (3) the sensory cortices [72,73], (4) the insula [70,71,73], (5) the ACC [35,70,71,[73][74][75], and (6) the prefrontal cortex [70,71,73,76]. Given the extensiveness of these previous reviews, this section will briefly review past research that has examined the neurophysiological effects of hypnotic analgesia, specifically focused on the role of suggestion type [35,72,77].…”