Psychological stress and wound healing in humans: what we know

The phenomenon of stress is a common human experience frequently blamed for much of the ill health individuals experience. Much focus has been given to the effect of stress on health and wellness. Research demonstrates a strong relationship between psychological stress and health including, but not limited to, poor surgical outcomes and a decrease in immune system functioning. The skin is the largest organ of the human body and is responsible for thermoregulation, vitamin D production, and protection from fluid loss, pathogens, ultraviolet radiation, and mechanical injury. The skin contains a vast supply of sensory nerves, providing sensory input on pain, temperature, pressure, and pleasure. Timely wound healing is of utmost importance because of the skin's vital protective and regulatory functions. Psychological stress has been shown to negatively impact wound healing, both directly and indirectly. The purpose of this review is to identify existing knowledge about the relationship between psychological stress and wound healing in order to provide the best evidence currently available on which to base recommendations for future research and to guide practice.