Wundmanagement
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Wundmanagement 6/2008
Wundheilung und Psyche
Overview
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Is there a link between woundhealing and psychological disorders?
K. Kröger
A systematic research in Pubmed, a medical database, covering the key words wound healing and emotion revealed 69 articles. Wound healing and psychologic disorders revealed 77 articles, wound healing and social support 103 and wound healing and depression 239. We summarized 5 articles from randomised controlled studies that reported the time course of wound healing in detail. These studies are representative for the systematic scientific approach to this problem and underline, that the influence of emotion on wound healing can not be ignored. All studies deal with acute artificial wounds and it remains unclear, how far these results can be transposed to chronic wounds.
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Psychoneuroimmunology and immune response: What we can learn for wound treatment
A. Schwarzkopf
Well known positive aspects of wound treatment are reduction of stress, pain and fever. But what are the effects in detail? Effects of so called eustress and distress are based on the interactions of produced hormones with immune cells and glucose metabolism. Immune response may be modulated positively or negatively and cells can stimulate the hypothalamus-hypophysis-adrenal body axis by cytokines. Pain reduction should guarantee an undisturbed sleep, because deficit of deep sleep causes malfunction of immune response. Chronic inflammatory processes should be avoided. Results of studies implicate, that even low doses of stress may cause shifts in microbial colonization of wounds and imbalance disturbing wound healing. As a consequence an individual stress management for every patient would be appropriate.
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Wound healing disturbance – narrative treatment
M Kütemeyer
Within the framework of the collaboration between the Departments of Plastic
Surgery, General Surgery and experts in psychomatics at St Agatha’s Hospital. Cologne, a correlation between delayed wound healing and emotional traumata
in the biography of the patients was discovered. Between 1990 and 2000 clinical courses of this form of wound healing disturbance were investigated systematically. The non-healing wound indicates the existence of an „emotional wound“ which has not healed, yet. Some clinical signs and symptoms such as enlargement or re-opening of a wound after initial healing, profuse secretions without signs of infection, varying sensations of pain, swelling, may be interpreted as attempts of the body to „communicate” traumatic experiences. Talking about these experiences and being understood can be viewed as emotional debridement which initiates the processing and disposal of pathogenic guilt-related introjects acting as foreign bodies. Eventually, the physical wound becomes redundant and can heal.
