Expressive writing and wound healing in older adults: a randomized controlled trial.
OBJECTIVE
To investigate whether expressive writing could speed wound reepithelialization in healthy, older adults.


METHODS
In this randomized controlled trial, 49 healthy older adults aged 64 to 97 years were assigned to write for 20 minutes a day either about upsetting life events (Expressive Writing) or about daily activities (Time Management) for 3 consecutive days. Two weeks postwriting, 4-mm punch biopsy wounds were created on the inner, upper arm. Wounds were photographed routinely for 21 days to monitor wound reepithelialization. Perceived stress, depressive symptoms, health-related behaviors, number of doctor visits, and lipopolysaccharide-stimulated proinflammatory cytokine production were also measured throughout the study.


RESULTS
Participants in the Expressive Writing group had a greater proportion of fully reepithelialized wounds at Day 11 postbiopsy compared with the Time Management group, with 76.2% versus 42.1% healed, χ(2)(1, n = 40) = 4.83, p = .028. Ordinal logistic regression showed more sleep in the week before wounding also predicted faster healing wounds. There were no significant group differences in changes to perceived stress, depressive symptoms, health-related behaviors, lipopolysaccharide-induced proinflammatory cytokine production, or number of doctor visits over the study period.


CONCLUSIONS
This study extends previous research by showing that expressive writing can improve wound healing in older adults and women. Future research is needed to better understand the underlying cognitive, psychosocial, and biological mechanisms contributing to improved wound healing from these simple, yet effective, writing exercises.


TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry (trial number 343095).
['Koschwanez|Heidi E|HE|', 'Kerse|Ngaire|N|', 'Darragh|Margot|M|', 'Jarrett|Paul|P|', 'Booth|Roger J|RJ|', 'Broadbent|Elizabeth|E|']
D000368:Aged D000369:Aged, 80 and over D003863:Depression D004644:Emotions D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D009520:New Zealand D062326:Re-Epithelialization D013315:Stress, Psychological D014945:Wound Healing D014956:Writing
expressive writing wound healing older adults randomized controlled trial reepithelialization