The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study

Astrid Meesters,Monique R T M Thissen,Yvo M C In Den Bosch-Meevissen,Madelon L Peters,Casper G Schalkwijk,Chantal A H Weijzen,Jan Schepers,Mario Losen,Wim A Buurman,Hugo J E M Alberts

doi:10.1007/s10865-017-9901-8

Abstract

Psychological factors have been shown to influence the process of wound healing. This study examined the effect of Mindfulness-Based Stress Reduction (MBSR) on the speed of wound healing. The local production of pro-inflammatory cytokines and growth factors was studied as potential underlying mechanism. Forty-nine adults were randomly allocated to a waiting-list control group (n = 26) or an 8-week MBSR group (n = 23). Pre- and post-intervention/waiting period assessment for both groups consisted of questionnaires. Standardized skin wounds were induced on the forearm using a suction blister method. Primary outcomes were skin permeability and reduction in wound size monitored once a day at day 3, 4, 5, 6, 7, and 10 after injury. Secondary outcomes were cytokines and growth factors and were measured in wound exudates obtained at 3, 6, and 22 h after wounding. Although there was no overall condition effect on skin permeability or wound size, post hoc analyses indicated that larger increases in mindfulness were related to greater reductions in skin permeability 3 and 4 days after wound induction. In addition, MBSR was associated with lower levels of interleukin (IL)-8 and placental growth factor in the wound fluid 22 h after wound induction. These outcomes suggest that increasing mindfulness by MBSR might have beneficial effects on early stages of wound healing. Trial Registration NTR3652, http://www.trialregister.nl

Highlights

Over the past decades studies have repeatedly shown that psychological factors can influence the process of wound healing (e.g. Broadbent and Koschwanez 2012; House 2015)
This study examined the effect of Mindfulness-Based Stress Reduction (MBSR) on the speed of wound healing
Multilevel random intercept modeling was conducted to test the effect of MBSR on change in Kentucky Inventory of Mindfulness Skills (KIMS), MAAS, LOTR, RRQ-reflection, and RRQ-rumination from pre- to postintervention

Summary

Introduction

Over the past decades studies have repeatedly shown that psychological factors can influence the process of wound healing (e.g. Broadbent and Koschwanez 2012; House 2015). Pro-inflammatory cytokines such as interleukin (IL)-1a, IL-1b, IL-6, IL-8 and tumor necrosis factor (TNF)- a are crucial during the early phases of the healing process, and for successful resolution of wounds. No main effect of the intervention was found but more intensive MBSR practice was associated with a decrease in TNF-a level from pre- to post-training in response to psychosocial stress and an inflammatory stimulus. We examined the effects of MBSR on pro-inflammatory cytokine and growth factor levels in wound fluid

Participants

Procedure

Results

Discussion

Compliance with ethical standards