Background: Human and animal laboratory studies have shown that stress delays healing of standardized punch biopsy wounds.Purpose: 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.
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This research was supported in part by National Institutes of Health (NIH) grants P50 DE13749, PO1 AG16321, and R37 MH42096; by NIH General Clinical Research Center Grant MO1-RR- 0034; and by Comprehensive Cancer Center Core Grant CA16058.We gratefully acknowledge the assistance of Laura von Hoene in data collection and the staff of the General Clinical Research Center for completing the punch biopsy standard wounds. We also thank Dr. Jennifer Haythornthwaite and Dr. Robert Edwards for their comments on a previous draft of this article.
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McGuire, L., Heffner, K., Glaser, R. et al. Pain and wound healing in surgical patients. ann. behav. med. 31, 165–172 (2006). https://doi.org/10.1207/s15324796abm3102_8