Pain and wound healing in surgical patients

McGuire, Lockhart B.; Heffner, Kathi L.; Glaser, Ronald; Needleman, Bradley J.; Malarkey, William B.; Dickinson, Stephanie; Lemeshow, Stanley; Cook, Charles H.; Muscarella, Peter; Melvin, W. Scott; Ellison, E. Christopher; Kiecolt‐Glaser, Janice K.

doi:10.1207/s15324796abm3102_8

Cited by 142 publications

(92 citation statements)

References 39 publications

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“…The findings of the observational studies, which provide evidence of an association between stress and healing, are supported by one of the intervention studies [47].T w o studies [42,49] reported nonsignificant findings and one [60] found that a diagnosis of posttraumatic stress disorder (PTSD) augmented healing. Another [45] did not find a statistically significant relationship between depression and levels of MMPs in wound fluid; however, they did find a negative relationship with physiological measures of stress.…”

Section: Main Finding From the Systematic Reviewmentioning

confidence: 88%

“…In contrast, comparison between the experimental punch biopsy wound studies [49,50,63,64,67,68] was facilitated by the fact that the wounds in these studies were of a standard size with reduced measurement variability. Indeed, most punch biopsy studies demonstrated the reliability and validity of their measurements.…”

Section: Discussionmentioning

confidence: 99%

“…However, this was the only study to examine PTSD and it could be argued that the experience of PTSD is qualitatively different from other conceptualizations of stress, since evidence exists that the physiological stress response differs in comparison to chronic stress [77,78] and therefore may have a different relationship to wound healing. Another [49] reported that depression was not associated with the healing of a punch biopsy wound. As acknowledged by the authors, the study may have been underpowered due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…Studies were excluded if they measured healing only by biomarkers due to the heterogeneity of factors assessed [43][44][45][46] and if there was not enough information available to calculate an effect size directly from the published paper. Data was requested from these authors [47-49]; however, two studies were excluded as the authors could not be contacted [49] or could not access the required data to allow calculation of an effect size r [48]. In addition, one [50] of the intervention studies [47,50] was excluded from the meta-analysis because it did not provide evidence concerning the strength of the relationship between stress and wound healing, as the intervention failed to change levels of stress.…”

Section: Data Synthesis For Meta-analysis Of a Subset Of Included Stumentioning

confidence: 99%

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

Walburn

Vedhara

Hankins

et al. 2009

Journal of Psychosomatic Research

281

187

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(2009) Psychological stress and wound healing in humans: a systematic review and meta-analysis. Journal of Psychosomatic Research, 67 (3). pp. [253][254][255][256][257][258][259][260][261][262][263][264][265][266][267][268][269][270][271] This version is available from Sussex Research Online: http://sro.sussex.ac.uk/2232/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Abstract Objective: The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing. 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) (Pb.01). 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.

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Section: Main Finding From the Systematic Reviewmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Data Synthesis For Meta-analysis Of a Subset Of Included Stumentioning

confidence: 99%

See 2 more Smart Citations

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

Walburn

Vedhara

Hankins

et al. 2009

Journal of Psychosomatic Research

281

187

View full text Add to dashboard Cite

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“…Specific surgical techniques might influence recovery time in the acute postoperative period [37][38][39]. The length of pain exposure in the acute postoperative period is associated with the development of chronic postsurgical pain [40,41]. Optimal pain reduction in the acute postoperative period seems to be important, not only for fast recovery and rehabilitation in the short-term, but for the prevention of CPSP as well [42,43].…”

Section: Discussionmentioning

confidence: 99%

Peri-operative pain in patients experiencing bariatric surgery

Kumar¹,

Soekarman²,

Singh³

et al. 2017

Med Clin Arch

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A review of the literature was performed to identify follow-up studies on pain and bariatric surgery (gastric band, gastric sleeve or R-en-Y gastric bypass) as intervention. The main objective of this study was to find information on the prevalence of chronic pain in patients undergoing any of the mentioned surgical techniques and the incidence of chronic postsurgical pain after bariatric surgery.16 studies were included for further analysis with over 2000 subjects. 2/3 of the information was on bypass surgery. "Short term" studies with data on pain within 3 months after surgery were randomized controlled trials (RCTs) comparing surgical techniques or analgesia. Pre-operative pain status had not been documented. However, peri-operative pain management was reported in detail. In 8 observational studies, pain data were available exceeding 3 months after surgery ("long term" studies). While pre-operative pain data were reported in the latter studies, in over half the anatomic location of the pain had not been specified. An accurate estimation of the incidence of chronic postsurgical pain after bariatric surgery was not possible based on the available data. The number of comparable studies was low and the anatomic location of the pain had not been specified. Data on pain between 1 week and 6 months after surgery are lacking. This period is important, since it contains the time point after which the measured pain can be defined as chronic.

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Psychological interventions for acute pain after open heart surgery

Tefikow¹,

Barth²,

Trelle³

et al. 2012

Cochrane Database of Systematic Reviews

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Background Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. Objectives To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery on pain, pain medication, mental distress, mobility, and time to extubation.

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Pain and wound healing in surgical patients

Abstract: ABSTRACT

Cited by 142 publications

References 39 publications

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

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

Peri-operative pain in patients experiencing bariatric surgery

Psychological interventions for acute pain after open heart surgery

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