Relaxation and Guided Imagery Techniques Improve Surgical Wound Healing

Brief training in relaxation and guided imagery techniques may help surgical patients experience faster healing, according to a study conducted at the University of Auckland, in New Zealand. Prior studies have shown that high stress levels can impair wound healing and that mental preparation of patients before surgery can reduce distress, pain, and time in hospital. Given this background, the University of Auckland researchers wanted to investigate whether a stress management intervention could improve surgical wound recovery. Their method involved measuring collagen deposition, an important factor in tissue healing.

Investigators randomly assigned 60 adult male and female laparoscopic cholecystectomy surgical patients to receive (1) standard care or (2) standard care plus 45 minutes of individual instruction in relaxation and guided imagery, as well as a take-home CD to listen to for 3 days before and 7 days after surgery. During the one-on-one instruction, a psychologist explained that stress could influence surgical outcomes and that relaxation could help with stress; the professional also led each participant through a deep-breathing and guided-imagery exercise.

The take-home CD included two guided sessions: one for surgery preparation, one for recovery. All subjects completed a preoperative questionnaire and a 7-day follow-up questionnaire, which included measurements of perceived stress. Investigators measured postsurgical fatigue and asked subjects how often they had used the CDs. Wound samples were taken from all subjects.

Data review revealed that those who participated in the relaxation and guided imagery activities had less stress and more hydroxyproline deposition in their wounds, indicating greater collagen synthesis. Changes in perceived stress, however, were not associated with more collagen deposition.

Lead study author, Elizabeth Broadbent, PhD, senior lecturer at the University of Auckland, said, “The significance of this study is that it is the first to show benefits of a psychological intervention on a quantitative, objective and validated measure of wound healing in surgery patients. It extends previous laboratory research to a clinical application. More research is recommended to investigate the efficacy of other types of psychological interventions and to see who benefits the most.”

These findings were published in the journal of the Psychoneuroimmunology Research Society, Brain, Behavior, and Immunity (2011; doi: 10.1016/j.bbi.2011.06.014).