The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe burn injury

Purpose: Severe burn injury leads to marked catabolism and decreased lean m ass, which can impair healing. Anabolic agents can attenuate net catabolism , Our purpose was to determine whether the testosterone analog, oxandrolone , given during the acute post burn period decreased the degree of nitrogen loss and loss of body weight while also increasing the healing rate of a sk in donor site. Materials and Methods: Patients with bums between 40% and 70% of body surfa ce were studied. A randomized double-blinded placebo-controlled study desig n was used. Patients were given oxandrolone 20 mg/day (n = 11) or a placebo 20 mg/day (n = 9) beginning between days 2 and 3 post burn. Net nitrogen b alance and the healing time of a standardized donor site were measured. Pat ients were monitored until transferred to a burn rehabilitation facility, a n average time period of 33 +/- 9 days. Results: Mean burn size was 49 +/- 8% for placebo and 53 +/- 9% of total bo dy surface for the oxandrolone group. Smoke inhalation was present in appro ximately 50% of patients in both groups. All patients survived the burn inj ury. Net weight loss was 8 +/- 3.1 kg in the placebo group compared with 3 +/- 1.9 kg in the oxandrolone group, a statistically significant decrease. Net daily nitrogen loss over a 3-week period (days 7 to 28) was 13 +/- 4 g in placebo treated compared with 4 +/- 1.9 g for the oxandrolone group, a s tatistically significant decrease. The healing time of a standardized donor site, decreased from the placebo group value of 13 +/- 3 days to 9 +/- 2 d ays for oxandrolone treated patients, a significant improvement. No major l iver dysfunction, or other complication attributable to an anabolic steroid was seen in either group. Conclusion: We found the anabolic agent, oxandrolone, significantly decreas ed weight loss and net nitrogen loss and increased donor site wound healing compared with placebo controls. We noted no complications with the use of oxandrolone. Copyright (C) 2000 by W.B. Saunders Company.