Surgery Clinical Trial
Official title:
The Effects of Stress Reduction on Surgical Wound Healing: A Randomised Controlled Trial
The purpose of this study is to investigate whether a stress reduction intervention prior to surgery can improve wound healing and recovery.The investigators hypothesise that patients who receive a psychological stress reduction intervention prior to surgery will report lower stress and higher perceived control, have lower stress hormones, better wound healing and better self-reported recovery than patients who receive standard care alone.
In previous prospective research, psychological stress has been shown to slow the healing of
small superficial wounds and impair surgical healing. We will investigate whether a
psychological intervention to reduce stress can improve surgical healing.
Ninety patients undergoing elective laparoscopic cholecystectomy will be randomised to
receive either standard care or a brief pre-surgical psychological intervention plus
standard care. Patients will complete a pre-surgical questionnaire to assess stress,
anxiety, depression, illness perceptions and current health, at least 3 days prior to
surgery. Then the intervention will be delivered. A second questionnaire on the morning of
surgery will reassess stress, anxiety and illness perceptions to see whether the
intervention has reduced stress and increased control perceptions. Plasma catecholamines and
salivary cortisol will be tested to assess the effectiveness of the intervention in reducing
stress-related hormones and to investigate their role in wound healing. During surgery 2
small expanded polytetrafluroethylene tubes will be inserted in the wound, which will be
removed after 7 days. Wound healing will be assessed by hydroxyproline and total protein
deposition in the tubes, as well as by the presence of wound infection. Patients'
post-surgical recovery, including pain and fatigue, will also be assessed. If this brief
psychological intervention can improve wound healing and aid recovery, it would provide a
simple strategy to improve outcomes in surgery.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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