Putting traumatic events on paper may aid healing after surgery, researchers predict.

A group of patients having major operations will be asked to write about their deepest, most troubling thoughts to see if this helps their surgical wounds heal faster.

There is a growing body of evidence that surgical wounds heal more quickly when a patient is less stressed, and that releasing pent-up feelings in writing may be beneficial.

Auckland University researchers will ask a group of patients scheduled for liver or pancreatic surgery to write about traumatic events in their lives. A comparison group will be asked to pen something much plainer: what's been happening in their day.

Measurements will be made in each patient of stress, mood, fatigue, and biological markers of immune response and wound healing.


The researchers say there is evidence that three 20-minute sessions of writing about personal emotional events can improve the healing of small, experimental wounds. But no one has yet studied the effects of expressive writing on the healing of wounds in surgical patients.

One of the researchers, Dr Elizabeth Broadbent, a senior lecturer in psychological medicine, said the intervention group patients would be asked to write about "the most upsetting or traumatic thing that's happened to them; preferably they haven't told anybody else about it.

"A lot of studies have looked at this expressive writing and found good, robust effects on health outcomes," she said.

"One theory is that if you have got something that's happened to you, for example your husband died and it's been very traumatic for you but you haven't really gotten over it yet, it's still in the back of your mind and it's taking up cognitive space.

"If you write about it, one of the thoughts is you process some of the thoughts and feelings that you've got about that event and therefore it's less of a load on your mind afterwards.

"One of the stress models is that if you have an acute stressor, your body activates to deal with the stressor ... [for instance] a car coming towards you: your heart rate goes up and your pupils dilate ...

"If the stressor is ongoing, your body is in a highly aroused state for a long time. You become exhausted, your immune system becomes less able to fight off any infections or is less able to respond to any event such as surgery."

Dr Broadbent and her colleagues last year published the results of a trial which showed benefits for patients taught relaxation techniques before having keyhole surgery to remove their gallbladder. Their surgical wounds had higher levels of hydroxyproline - an amino acid and a major component of collagen - indicating they were healing faster. They were also less stressed and less fatigued than other patients.


The study

*The funding source: Auckland Medical Research Foundation
*The sum: $151,616
*The question: Does writing about traumatic events in your life aid healing of surgical wounds?