Wound Healing

Wound Healing, Stress and Inflammation

                           By

Aysha Siddiqui

 Dr.Debra Wilson- PSYC 6747

Walden University

Wound Healing and Inflammation

Influences of Inflammation on Wound healing

            Wound healing is a series of interactions and reactions among cells and mediators unlike the simple three step process of ‘inflammation, proliferation and maturation’ (Broughton, Janis, Attinger, 2006).Many researchers however, do explain wound healing in four steps; hemostasis, inflammation, proliferation and remodeling (Diegelmann, Evans, 2004). The healing process starts immediately after a tissue injury, when platelets come into contact with the collagen after blood components spill into the injury site. This contact starts the clotting process and the growth of essential cytokines such as platelet derived growth factor (PDGF) and gorwoth factor beta (TGF-B) (Diegelmann, Evans, 2004). The activities during wound healing is directed by chemical signals that are growth factors or cytokines which have been recently understood after observing enzyme expression, matrix production being part of the process. Singer, Clark (1999) describe wound healing as a three phase process-inflammation, tissue formation and tissue remodeling.

Influences of Stress on Wound Healing

            Kiecolt-Glaser et al., (1995) study showed that stress related incidents can have clinical effects on biological processes like wound healing or recovery from surgery. Their study took two groups of 13 women each with one controlled group that cared for Alzheimer’s patients and the other not doing that but being same in age, economic status. All participants underwent a 3-5mm biopsy wound and the results showed that caregivers healing process was much longer than the other group. Another study conducted by Ebrecht et al., (2004) showed that wound healing among healthy men is influenced by stress and not by any other health related issues like smoking, alcohol or sleeping etc. The article explains that the level cortisol is affected times of stress and this has a direct connection to the wound healing process.

            Some researchers connect the stressors to the function of the immune system and the central nervous system. Godbout, Glaser (2006) highlights that physiological stress impairs wound healing by affecting the initial inflammation phase of repair, and stress induced wound healing can lead to hospitalizations.  Wound healing being affected by stressors in life is sometimes connected to how the hormones, obesity, medication, nutrition and other conditions like diabetes, blood pressure react to stress (Guo, DiPietro, 2010)..

Experiment to examine Stress Management Techniques

For our experiment we would target a specific aging population that is susceptible to wound healing and also high risk for stress. We will target the lower socioeconomic status (SES) aging population that suffers from some chronic disease already. Research shows that individuals who are facing and managing any kind of chronic illness are sufferers of stress much more than the normal population (Felton, Revenson, 1984). Added to this past literature review also reveals that aging population from lower SES is at higher health risks that include wounds, psychological pressures, chronic illnesses (House et al, 1994). House et al. (1994) explains that in lower SES population, individual’s health declines in middle age compared to other populations that may see signs of aging health in older age.

Our experiment would aim to educate this specific population about wound healing, its connection to inflammation and most importantly how stress can hinder the healing process. The goal of our project would be to equip the population with techniques, tools to handle stress better so it would improve the overall health. This way when wound healing is required by the body, stress in not an active factor in hindering the process.

  References

Broughton 2nd, G., Janis, J. E., & Attinger, C. E. (2006). The basic science of wound healing. Plastic and reconstructive surgery, 117(7 Suppl), 12S-34S.

Diegelmann, R. F., & Evans, M. C. (2004). Wound healing: an overview of acute, fibrotic and delayed healing. Front Biosci, 9(1), 283-289.

Ebrecht, M., Hextall, J., Kirtley, L. G., Taylor, A., Dyson, M., & Weinman, J. (2004). Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology, 29(6), 798-809.

Felton, B. J., & Revenson, T. A. (1984). Coping with chronic illness: a study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of consulting and clinical psychology, 52(3), 343.

Godbout, J. P., & Glaser, R. (2006). Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. Journal of Neuroimmune Pharmacology, 1(4), 421-427.

Guo, S., & DiPietro, L. A. (2010). Factors affecting wound healing. Journal of dental research, 89(3), 219-229.

House, J. S., Lepkowski, J. M., Kinney, A. M., Mero, R. P., Kessler, R. C., & Herzog, A. R. (1994). The social stratification of aging and health. Journal of Health and Social Behavior, 213-234.

Kiecolt-Glaser, J. K., Marucha, P. T., Mercado, A. M., Malarkey, W. B., & Glaser, R. (1995). Slowing of wound healing by psychological stress. The Lancet, 346(8984), 1194-1196.

Singer, A. J., & Clark, R. A. (1999). Cutaneous wound healing. New England journal of medicine, 341(10), 738-746.