title: Stress predicts the trajectory of wound healing in living kidney donors as measured by high-resolution ultrasound.
abstract: BACKGROUND
  Psychological stress has been shown to be an influential factor on the rate of wound healing; however these findings have been demonstrated predominantly on artificially created wounds. Due to the absence of major co-morbidities, living kidney donors are a unique group in which to study this relationship. This study investigated the effect of preoperative stress and personality on surgical wound healing through the use of high-resolution ultrasound.
  
  
  METHODS
  Living kidney donors due to undergo a hand-assisted laparoscopic donor nephrectomy were asked to complete the Perceived Stress Scale, the Life Orientation Test-Revised and the Ten Item Personality Inventory prior to surgery. High-resolution ultrasound scans of surgical wounds were performed on the first three post-operative days and once following discharge (mean=15.3 days; s.d. 2.8). Two measurements from each image were obtained: wound width (size of wound) and median intensity (a marker of tissue fluid). Latent Growth Curve Models (LGCMs) were used to evaluate wound healing.
  
  
  RESULTS
  52 living kidney donors participated. Higher pre-operative life stress, lower optimism and lower conscientiousness were associated with delayed wound healing in living kidney donors for both outcomes. Increased emotional stability was associated with faster wound healing as demonstrated by a change in median intensity. Possible confounding factors, such as age, BMI, smoking status, local anaesthetic use and wound drain placement were not influential.
  
  
  CONCLUSIONS
  This study, which measured wound healing in a novel patient sample using a novel technique, has demonstrated a negative association between stress and wound healing and the positive influence of optimism, conscientiousness and emotional stability.
authors: Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, Department of Transplantation, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: Hannah.Maple@gstt.nhs.uk.
authors: Hannah
authors: H
authors: Maple
authors: Health Psychology Section, Institute of Psychiatry, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: Joseph.Chilcot@kcl.ac.uk.
authors: Joseph
authors: J
authors: Chilcot
authors: Health Psychology Section, Institute of Psychiatry, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: van_lee88@hotmail.com.
authors: Vanessa
authors: V
authors: Lee
authors: Health Psychology Section, Institute of Psychiatry, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: Shanique.Simmons@kcl.ac.uk.
authors: Shanique
authors: S
authors: Simmonds
authors: Health Psychology Section, Institute of Psychiatry, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: John.Weinman@kcl.ac.uk.
authors: John
authors: J
authors: Weinman
authors: Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, Department of Transplantation, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: Nizam.Mamode@gstt.nhs.uk.
authors: Nizam
authors: N
authors: Mamode
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000523:psychology*; D010551:Personality / Q000502:physiology; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000523:psychology*; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
keywords: Kidney donor; Personality; Stress; Transplant; Transplantation; Wound healing