Pain and wound healing in surgical patients.
BACKGROUND
Human and animal laboratory studies have shown that stress delays healing of standardized punch biopsy wounds.


OBJECTIVE
This 5-week prospective study of 17 women who underwent elective gastric bypass surgery addressed the association between postsurgical pain intensity and subsequent healing of a standard 2.0-mm punch biopsy wound.


METHODS
Participants were assessed 1 week before surgery, within 3 hr before surgery, 1 to 3 days postsurgery, and at weekly intervals for 4 weeks following surgery.


RESULTS
Patient ratings of greater acute postsurgical pain, averaged over Days 1 and 2 postsurgery, and greater persistent postsurgical pain, averaged over 4 weekly postsurgery pain ratings, were significantly associated with subsequent delayed healing of the punch biopsy wound. Presence of depressive symptoms on the day of surgery, pre-existing persistent pain, and medical complications following initial discharge from the hospital were not related to wound healing. Depressive symptoms on the day of surgery and pre-existing persistent pain did predict persistent postsurgical pain intensity.


CONCLUSIONS
These findings extend the previous laboratory models of wound healing to a surgical population, providing the first evidence that pain plays an important role in postsurgery wound healing, a key variable in postsurgical recovery.
Psychology Department, University of Maryland Baltimore County, 21250, USA. lmcguire@umbc.edu
Lynanne
L
McGuire
Kathi
K
Heffner
Ronald
R
Glaser
Bradley
B
Needleman
William
W
Malarkey
Stephanie
S
Dickinson
Stanley
S
Lemeshow
Charles
C
Cook
Peter
P
Muscarella
William Scott
WS
Melvin
Edwin Christopher
EC
Ellison
Janice K
JK
Kiecolt-Glaser
D000328:Adult; D003863:Depression / Q000523:psychology; D017558:Elective Surgical Procedures; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D010146:Pain; D011446:Prospective Studies; D013997:Time Factors; D014945:Wound Healing