The anabolic steroid, oxandrolone, reverses the wound healing impairment in corticosteroid-dependent burn and wound patients

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.