Intensive insulin treatment increases donor site wound protein synthesis in burn patients

Demidmaa Tuvdendorj, Xiao Jun Zhang, David L. Chinkes, Asle Aarsland, Gabriela A. Kulp, Marc G. Jeschke, David Herndon

Research output: Contribution to journalArticle

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Abstract

Background: In the treatment of burns, patients' own skin is the preferred material to cover burn wounds, resulting in the need to create a donor site wound. Enhancement of healing of the donor site wound would be beneficial in burn patients. Insulin, an anabolic agent, is used routinely to treat hyperglycemia after injury. We investigated whether intensive insulin treatment increases fractional synthesis rate (FSR) of the donor site wound protein and decreases the length of hospitalization normalized for total body surface area burned (LOS/TBSA). Methods: FSR of the donor site wound protein was measured in pediatric patients randomized to control (n = 13) and insulin (n = 10) treatments. Depending on the postoperative day when the tracer study was done, studies were divided into "early" (days < 5) and "late" (days ≥ 5) periods. Results: FSR of the donor site wound protein was greater in the insulin group at the "early" period of wound healing (control vs insulin, 8.2 ± 3.8 vs 13.1 ± 6.9% per day; P < .05); but not at the "late" (control vs insulin, 19.7 ± 4.6 vs 16.6 ± 4.0% per day; P > .05). Despite these differences, LOS/TBSA was not decreased in the insulin group. Correlation analyses demonstrated that, independent of the treatment regimen, FSR positively correlated (P < .05) with time after creation of the donor site and negatively correlated (P < .05) with LOS/TBSA. Conclusion: Insulin treatment increased FSR of the donor site wound protein in the early period of wound healing; FSR correlated with LOS/TBSA independent of the treatment regimen.

Original languageEnglish (US)
Pages (from-to)512-518
Number of pages7
JournalSurgery
Volume149
Issue number4
DOIs
StatePublished - Apr 2011

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Tissue Donors
Insulin
Wounds and Injuries
Proteins
Therapeutics
Anabolic Agents
Body Surface Area
Burns
Hyperglycemia
Wound Healing
Hospitalization
Pediatrics
Skin

ASJC Scopus subject areas

  • Surgery

Cite this

Tuvdendorj, D., Zhang, X. J., Chinkes, D. L., Aarsland, A., Kulp, G. A., Jeschke, M. G., & Herndon, D. (2011). Intensive insulin treatment increases donor site wound protein synthesis in burn patients. Surgery, 149(4), 512-518. https://doi.org/10.1016/j.surg.2010.10.021

Intensive insulin treatment increases donor site wound protein synthesis in burn patients. / Tuvdendorj, Demidmaa; Zhang, Xiao Jun; Chinkes, David L.; Aarsland, Asle; Kulp, Gabriela A.; Jeschke, Marc G.; Herndon, David.

In: Surgery, Vol. 149, No. 4, 04.2011, p. 512-518.

Research output: Contribution to journalArticle

Tuvdendorj, D, Zhang, XJ, Chinkes, DL, Aarsland, A, Kulp, GA, Jeschke, MG & Herndon, D 2011, 'Intensive insulin treatment increases donor site wound protein synthesis in burn patients', Surgery, vol. 149, no. 4, pp. 512-518. https://doi.org/10.1016/j.surg.2010.10.021
Tuvdendorj, Demidmaa ; Zhang, Xiao Jun ; Chinkes, David L. ; Aarsland, Asle ; Kulp, Gabriela A. ; Jeschke, Marc G. ; Herndon, David. / Intensive insulin treatment increases donor site wound protein synthesis in burn patients. In: Surgery. 2011 ; Vol. 149, No. 4. pp. 512-518.
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AU - Tuvdendorj, Demidmaa

AU - Zhang, Xiao Jun

AU - Chinkes, David L.

AU - Aarsland, Asle

AU - Kulp, Gabriela A.

AU - Jeschke, Marc G.

AU - Herndon, David

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N2 - Background: In the treatment of burns, patients' own skin is the preferred material to cover burn wounds, resulting in the need to create a donor site wound. Enhancement of healing of the donor site wound would be beneficial in burn patients. Insulin, an anabolic agent, is used routinely to treat hyperglycemia after injury. We investigated whether intensive insulin treatment increases fractional synthesis rate (FSR) of the donor site wound protein and decreases the length of hospitalization normalized for total body surface area burned (LOS/TBSA). Methods: FSR of the donor site wound protein was measured in pediatric patients randomized to control (n = 13) and insulin (n = 10) treatments. Depending on the postoperative day when the tracer study was done, studies were divided into "early" (days < 5) and "late" (days ≥ 5) periods. Results: FSR of the donor site wound protein was greater in the insulin group at the "early" period of wound healing (control vs insulin, 8.2 ± 3.8 vs 13.1 ± 6.9% per day; P < .05); but not at the "late" (control vs insulin, 19.7 ± 4.6 vs 16.6 ± 4.0% per day; P > .05). Despite these differences, LOS/TBSA was not decreased in the insulin group. Correlation analyses demonstrated that, independent of the treatment regimen, FSR positively correlated (P < .05) with time after creation of the donor site and negatively correlated (P < .05) with LOS/TBSA. Conclusion: Insulin treatment increased FSR of the donor site wound protein in the early period of wound healing; FSR correlated with LOS/TBSA independent of the treatment regimen.

AB - Background: In the treatment of burns, patients' own skin is the preferred material to cover burn wounds, resulting in the need to create a donor site wound. Enhancement of healing of the donor site wound would be beneficial in burn patients. Insulin, an anabolic agent, is used routinely to treat hyperglycemia after injury. We investigated whether intensive insulin treatment increases fractional synthesis rate (FSR) of the donor site wound protein and decreases the length of hospitalization normalized for total body surface area burned (LOS/TBSA). Methods: FSR of the donor site wound protein was measured in pediatric patients randomized to control (n = 13) and insulin (n = 10) treatments. Depending on the postoperative day when the tracer study was done, studies were divided into "early" (days < 5) and "late" (days ≥ 5) periods. Results: FSR of the donor site wound protein was greater in the insulin group at the "early" period of wound healing (control vs insulin, 8.2 ± 3.8 vs 13.1 ± 6.9% per day; P < .05); but not at the "late" (control vs insulin, 19.7 ± 4.6 vs 16.6 ± 4.0% per day; P > .05). Despite these differences, LOS/TBSA was not decreased in the insulin group. Correlation analyses demonstrated that, independent of the treatment regimen, FSR positively correlated (P < .05) with time after creation of the donor site and negatively correlated (P < .05) with LOS/TBSA. Conclusion: Insulin treatment increased FSR of the donor site wound protein in the early period of wound healing; FSR correlated with LOS/TBSA independent of the treatment regimen.

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