The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe burn injury.
OBJECTIVE
Severe burn injury leads to marked catabolism and decreased lean mass, 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 skin donor site.


METHODS
Patients with burns between 40% and 70% of body surface were studied. A randomized double-blinded placebo-controlled study design 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 balance and the healing time of a standardized donor site were measured. Patients were monitored until transferred to a burn rehabilitation facility, an average time period of 33 +/- 9 days.


RESULTS
Mean burn size was 49 +/- 8% for placebo and 53 +/- 9% of total body surface for the oxandrolone group. Smoke inhalation was present in approximately 50% of patients in both groups. All patients survived the burn injury. 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 statistically significant decrease. The healing time of a standardized donor site, decreased from the placebo group value of 13 +/- 3 days to 9 +/- 2 days for oxandrolone treated patients, a significant improvement. No major liver dysfunction, or other complication attributable to an anabolic steroid was seen in either group.


CONCLUSIONS
We found the anabolic agent, oxandrolone, significantly decreased 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.
Demling
R H
RH
The Burn Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Orgill
D P
DP
D000328:Adult; D000368:Aged; D045930:Anabolic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002056:Burns / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004311:Double-Blind Method; D002149:Energy Intake; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008875:Middle Aged; D010074:Oxandrolone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010919:Placebos; D014945:Wound Healing / Q000187:drug effects*
D045930:Anabolic Agents; D010919:Placebos; D010074:Oxandrolone