IMPACT OF PREOPERATIVE PSYCHOLOGICAL STRESS ON WOUND HEALING AND RECOVERY FOLLOWING ELECTIVE ABDOMINAL SURGERY AT AYUB TEACHING HOSPITAL, ABBOTTABAD

Abstract

Background: Psychological stress before surgery is common and may adversely affect surgical outcomes. This study examined the impact of preoperative psychological stress on wound healing and recovery in patients undergoing elective abdominal surgery at a tertiary hospital.

Methods: In a prospective cohort design, 100 adults scheduled for elective abdominal procedures were assessed for stress using the Perceived Stress Scale (PSS) and serum cortisol levels preoperatively. Patients were categorized into high-stress (PSS > 20) and low-stress groups. Wound healing time (days to complete incision healing), occurrence of wound infection, and postoperative recovery indices (hospital stay length and complications) were recorded.

Results: Patients with high preoperative stress (n = 40) had significantly longer wound healing times (mean 18.7 vs 15.1 days, p < 0.001) and a higher rate of surgical wound infections (32.5% vs 6.7%, p = 0.001) compared to low-stress patients. Preoperative cortisol levels were elevated in the high-stress group and correlated positively with healing time (r ≈ 0.69), indicating that greater physiological stress was associated with slower wound repair. High-stress patients also required slightly longer hospital stays (mean 6.0 vs 5.0 days, p = 0.002).

Conclusion: Elevated preoperative psychological stress is associated with delayed wound healing, increased risk of wound infection, and prolonged recovery in elective abdominal surgery patients. These findings underscore the importance of identifying and managing preoperative stress to potentially improve surgical outcomes. Implementing stress-reduction interventions before surgery may enhance wound healing and overall recovery.