Researchers at the University of Auckland in New Zealand investigated whether a brief psychological intervention, using relaxation and guided imagery, could reduce stress and improve wound healing in surgical patients.

The randomized controlled trial was conducted with 60 patients (15 male, 45 female). Inclusion criteria were English-speaking patients over 18 years of age, scheduled to undergo elective laparoscopic gallbladder removal.  Exclusion criteria were cancellation of surgery, medical complications, and refusal of consent.

Participants received standard care or standard care plus a 45-minute psychological intervention that included relaxation and guided imagery, with take-home relaxation CDs for listening for 3 days before and 7 days after surgery.

In both groups teflon tubes were inserted during surgery and removed at 7 days after surgery, and analyzed for hydroxyproline as a measure of collagen deposition and wound healing.
Change in perceived stress from before surgery to 7-day follow-up was assessed using questionnaires. Intervention group patients showed a reduction in perceived stress compared with the control group, controlling for age.
Patients in the intervention group had significantly higher hydroxyproline deposition in the wound than did control group patients (difference in means 0.35, 95% CI 0.66-0.03; t(43)=2.23, p=0.03). Changes in perceived stress were not associated with hydroxyproline deposition.

The investigators conclude that a brief relaxation intervention prior to surgery can reduce stress and improve the wound healing response in surgical patients. They also suggest that this intervention may have particular clinical application for those at risk of poor healing following surgery.

Citation:  Broadbent E, Kahokehr A, Booth RJ, Thomas J, Windsor JA, Buchanan CM, Wheeler BR, Sammour T, Hill AG. A brief relaxation intervention reduces stress and improves surgical wound healing response: A randomised trial. Brain, Behavior and Immunity. 2011 Jun 28. [Epub ahead of print]