GROWTH-HORMONE IN SURGERY - CURRENT STATE OF KNOWLEDGE

The first clinical studies with the application of growth hormone (GH) under postoperative and post-traumatic conditions date back to the ea rly 1960s. The introduction of recombinant human growth hormone made t he drug generally available for clinical studies. Administration of GH after elective general surgery improves nitrogen balance. Interruptio n of the post-traumatic hypermetabolism has been occasionally describe d, but most studies only demonstrate a slight reduction of the catabol ic response. An increasing number of papers report positive influence of GH on wound healing, especially skin graft donor sites. The impact on the immune system has yet to be clarified. This paper gives an comp rehensive overview of the current state of knowledge of the clinical e ffect of GH in various surgical specialities with special respect to s eptic conditions, burns, trauma, and wound healing.