PSYCHOLOGICAL AND PHYSIOLOGICAL STRESS

As well as delaying wound healing through raised serum levels of corticosteroids, stress also delays wound healing due to stimulation of the sympathetic nervous system.

In both animals and humans, it is well accepted that chronic stress delays dermal wound healing. This occurs through activation of both the HPA (hypothalamic pituitary adrenal) axis and SNS (sympathetic nervous system) pathways. Through these pathways, stress dysregulates the early wound repair process, prolonging the inflammatory phase of healing (Granstein & Luger, 2008).

It is important to involve the patient in all decisions made regarding the management of their wound, as this will help reduce their stress levels. This will also help to increase the likelihood that patients will follow the advice and treatment regimen prescribed by the health professional.