Rh. Demling et L. Desanti, The anabolic steroid, oxandrolone, reverses the wound healing impairment in corticosteroid-dependent burn and wound patients, WOUNDS, 13(5), 2001, pp. 203-208
Citations number
28
Categorie Soggetti
Dermatology
Journal title
WOUNDS-A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE
Exogenous corticosteroid administration is known to impair wound healing. P
atients with severe burns or wounds who require corticosteroids for managem
ent of an underlying disease have an increased rate of catabolism and decre
ased rate of healing. Anabolic steroids have been reported to restore anabo
lism and wound healing. Our objective was to determine if the oral anabolic
steroid oxandrolone could increase the rate of wound healing by decreasing
the rate of catabolism in corticosteroid-dependent patients with burns and
partial-thickness wounds. Twenty-two corticosteroid-dependent patients wit
h major burns (12) or skin slough disorders (10) were studied. All burn pat
ients required a skin graft, and reepithelialization of the donor site was
used as a marker of healing. The skin slough disorders were all partial thi
ckness, and reepithelialization of the wounds was the marker for healing. T
he burns and skin slough disorders were divided into a standard care group
and standard care plus oxandrolone (20 mg/day) group. The disorders requiri
ng corticosteroids were collagen vascular disease (12), organ transplant (4
), and asthma, or other respiratory diseases (6). Twenty patients survived.
The two deaths were in patients with progressive graft versus host disease
. No complications relative to the control of the underlying disease were n
oted with. use of the anabolic steroid. We found that the time to healing o
f skin donor sites in the standard care group was 20 +/- 4 days compared to
13 +/- 3 days in the oxandrolone-treatment burn group, a significant diffe
rence (p < 0.05), We found that the time to reepithelialization in the skin
slough disorders with standard care was 25 +/- 6 days compared to 17 +/- 4
days with the addition of oxandrolone, also a significant difference (p <
0.05). Weight loss was 50-percent less with the addition of oxandrolone com
pared to standard care, also a significant difference (p < 0.05). We can co
nclude that providing an anabolic steroid to a corticosteroid-dependent bur
n or wound patient eliminates the impaired wound healing.