Depression or Anxiety May Increase the Risk of Surgical Wound Complications

    Patients’ mental health may affect their risk of experiencing wound-related complications after surgery, according to a study from the University of Manchester in the UK.

    The study, published by the British Journal of Surgery, included nearly 177,000 patients in England who underwent 1 of 4 surgical procedures between 2009 and 2011:

    • Hip replacement, n=59,410
    • Knee replacement, n=64,145
    • Hernia repair, n=38,328
    • Varicose vein treatment, n=14,944

    The researchers used pre- and postoperative observational data to determine if there was a relationship between 3 measures of anxiety and/or depression and 7 adverse surgical outcomes.

    They found that hip replacement patients with moderate anxiety or depression had a 1.17-times greater likelihood of experiencing wound complications after surgery than patients who did not have anxiety or depression.

    These patients also had a 1.20-times greater likelihood of being readmitted for a wound complication, and they had longer durations of hospital stay on average.

    Similar results were seen across the other 3 types of surgery and were larger for patients with extreme anxiety or depression.”This relationship warrants further exploration in order to understand the mechanisms and potential opportunities for intervention,” said Philip Britteon, BSc, MSc, lead study author and a PhD student at the University of Manchester.

    “The study also emphasizes the importance of the psychological state before surgery, and the fact that psychological disorders are often overlooked.

    “Preoperative assessment should address psychological as well as physical health, given the significant impact of anxiety/depression on wound-related complications and readmissions.”


    Britteon P, Cullum N, Sutton M. Association between psychological health and wound complications after surgery. British Journal of Surgery. Published online February 14, 2017. doi: 10.1002/bjs.10474.