title: The use of wound healing assessment methods in psychological studies: a review and recommendations.
abstract: OBJECTIVE
  To provide a critical review of methods used to assess human wound healing in psychological research and related disciplines, in order to guide future research into psychological influences on wound healing.
  
  
  METHODS
  Acute wound models (skin blister, tape stripping, skin biopsy, oral palate biopsy, expanded polytetrafluoroethylene tubing), surgical wound healing assessment methods (wound drains, wound scoring), and chronic wound assessment techniques (surface area, volumetric measurements, wound composition, and assessment tools/scoring systems) are summarized, including merits, limitations, and recommendations.
  
  
  RESULTS
  Several dermal and mucosal tissue acute wound models have been established to assess the effects of psychological stress on the inflammatory, proliferative, and repair phases of wound healing in humans, including material-based models developed to evaluate factors influencing post-surgical recovery. There is a paucity of research published on psychological factors influencing chronic wound healing. There are many assessment techniques available to study the progression of chronic wound healing but many difficulties inherent to long-term clinical studies.
  
  
  CONCLUSIONS
  Researchers need to consider several design-related issues when conducting studies into the effects of psychological stress on wound healing, including the study aims, type of wound, tissue type, setting, sample characteristics and accessibility, costs, timeframe, and facilities available. Researchers should consider combining multiple wound assessment methods to increase the reliability and validity of results and to further understand mechanisms that link stress and wound healing.
authors.affiliation: Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Koschwanez
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Broadbent
mesh_terms: D006801:Humans; D011183:Postoperative Complications / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology*; D014945:Wound Healing; D014947:Wounds and Injuries / Q000150:complications* / Q000523:psychology*