Patients suffering severe
burns have an accelerated catabolism with a highly negative
nitrogen balance that may worsen their prognosis.
Somatropin treatment has been shown to improve this balance in different hypercatabolic situations. Moreover, in children with extensive
burns it also reduces the healing time of the skin graft donor site and shortens the
hospital stay. In the existing literature there are no controlled prospective clinical trials in adult patients that confirm these data. Our aim was to demonstrate the efficacy of
recombinant growth hormone (
somatropin) in reducing the healing time of the skin graft donor sites and the
length of stay in the burn unit in adult patients with severe
burns. A randomized, double-blind, placebo-controlled clinical trial was carried out in 24 adult patients with severe
burns (more than 40% of the total body surface burned or more than 15% full-thickness
burns). Patients received placebo (n = 11) or
somatropin (n = 13) at a dosage of 0.15 mg/kg/day divided into two equal doses (every 12 hours) via
intramuscular injection. Treatment was initiated the day the first autograft was performed and terminated the day the patient was discharged from the burn unit. The mean number (+/- SD) of skin grafts per patient was similar between the two groups (4.2 +/- 1.8 vs 3.4 +/- 1.8 in the placebo and
somatropin groups, respectively). No reduction in the healing time of the skin graft donor site was observed in the
somatropin group compared to the placebo group. Likewise, the time admitted to the burn unit was not significantly different, either in the absolute number of days (36.2 +/- 19.7 vs 30.1 +/- 16.8 days in the placebo and
somatropin groups, respectively) or in relation to the percentage of the total body surface burned or the body surface with full-thickness
burns.
Growth hormone and
insulin-like growth factor I (
IGF-I) levels were three and five times higher, respectively, in the
somatropin group than in the placebo group. Ten of the patients treated with
somatropin experienced
hyperglycemia, and seven of them required
insulin treatment. No other adverse side effect was observed. One patient in the placebo group died as a result of
sepsis and
multiple organ failure.
Somatropin, with the treatment regimen and dosage used in these studies, did not reduce the healing time of the skin graft donor sites or the length of hospitalization in the burn unit in adult patients with severe
burns.