Stress Is Bad News for Surgical Wounds

If you’re considering elective surgery, you may want to factor your stress level into account when you decide to have it, suggests research from the University of Illinois. Why? Because researchers found that wounds heal slower and are at greater risk of infection during stressful times.

At the University of Illinois in Chicago, Christopher G. Engeland, PhD, assistant professor of periodontics, worked with a team of researchers to examine the impact of stress on wounds to mucosal tissue in the mouth. They assessed wound closure rates in 65 dental students who volunteered to receive two small wounds (under local anesthesia) to the hard palate of the mouth on two different occasions — during exam week and during summer vacation. The students’ healing rates and inflammatory responses were assessed regularly afterward.

During the presumably stressful exam weeks, researchers found elevated levels of inflammation in tissue and a delay in healing time of approximately 20%… and other stress studies have found it to be even higher. Any delay in wound closure increases infection risks, a fact that makes these findings particularly important, warns Dr. Engeland — noting that researchers were interested to see that “a stressor as relatively mild as university exams can delay healing rates, even in experienced students.” The findings were reported on March 5, 2009, at the 67th annual meeting of the American Psychosomatic Society in Chicago.

WHAT TO DO

Dr. Engeland recommends not scheduling elective surgery (e.g., wisdom tooth removal) during or immediately after any period of added anxiety. He noted that if you have other medical issues that are known to slow healing, such as advanced age or diabetes, it’s important to recognize that adding stress to the mix will make matters even worse. Pain, too, is a stressor, so don’t assume it is better to “tough it out” rather than take pain medication. Relaxation techniques, massage therapy, meditation and other natural modalities have been shown to help reduce pre- and post-surgical stress and can improve healing outcomes.

Dr. Engeland notes that this research focused specifically on mucosal healing in the mouth, adding that it is likely also true for other mucosal tissue (for instance, in the gastrointestinal tract) but further research is required to learn more.