Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

David Herndon, Karel D. Capek, Evan Ross, Jayson W. Jay, Anesh Prasai, Amina El Ayadi, Guillermo Foncerrada Ortega, Elizabeth Blears, Christian Sommerhalder, Kara McMullen, Dagmar Amtmann, Robert Cox, Gabriel Hundeshagen, Kristofer Jennings, Linda Sousse, Oscar Suman, Walter Meyer, Celeste Finnerty

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Massive burns induce a hypermetabolic response that leads to total body wasting and impaired physical and psychosocial recovery. The administration of propranolol or oxandrolone positively affects postburn metabolism and growth. The combined administration of oxandrolone and propranolol (OxProp) for 1 year restores growth in children with large burns. Here, we investigated whether the combined administration of OxProp for 1 year would reduce scarring and improve quality of life compared with control.

STUDY DESIGN: Children with large burns (n = 480) were enrolled into this institutional review board-approved study; patients were randomized to control (n = 226) or administration of OxProp (n = 126) for 1 year postburn. Assessments were conducted at discharge and 6, 12, and 24 months postburn. Scar biopsies were obtained for histology. Physical scar assessments and patient reported outcome measures of physical and psychosocial function were obtained.

RESULTS: Reductions in cellularity, vascular structures, inflammation, and abnormal collagen (P < 0.05) occurred in OxProp-treated scars. With OxProp, scar severity was attenuated and pliability increased (both P < 0.05). Analyses of patient-reported outcomes showed improved general and emotional health within the OxProp-treated group (P < 0.05).

CONCLUSIONS: Here, we have shown improvements in objective and subjective measures of scarring and an increase in overall patient-reported physical function. The combined administration of OxProp for up to a year after burn injury should be considered for the reduction of postburn scarring and improvement of long-term psychosocial outcomes in children with massive burns.

Original languageEnglish (US)
Pages (from-to)431-441
Number of pages11
JournalAnnals of Surgery
Volume268
Issue number3
DOIs
StatePublished - Sep 1 2018

Fingerprint

Oxandrolone
Propranolol
Cicatrix
Burns
Research Ethics Committees
Growth
Pliability
Blood Vessels
Histology
Collagen
Quality of Life
Inflammation
Biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol. / Herndon, David; Capek, Karel D.; Ross, Evan; Jay, Jayson W.; Prasai, Anesh; Ayadi, Amina El; Foncerrada Ortega, Guillermo; Blears, Elizabeth; Sommerhalder, Christian; McMullen, Kara; Amtmann, Dagmar; Cox, Robert; Hundeshagen, Gabriel; Jennings, Kristofer; Sousse, Linda; Suman, Oscar; Meyer, Walter; Finnerty, Celeste.

In: Annals of Surgery, Vol. 268, No. 3, 01.09.2018, p. 431-441.

Research output: Contribution to journalArticle

Herndon, D, Capek, KD, Ross, E, Jay, JW, Prasai, A, Ayadi, AE, Foncerrada Ortega, G, Blears, E, Sommerhalder, C, McMullen, K, Amtmann, D, Cox, R, Hundeshagen, G, Jennings, K, Sousse, L, Suman, O, Meyer, W & Finnerty, C 2018, 'Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol', Annals of Surgery, vol. 268, no. 3, pp. 431-441. https://doi.org/10.1097/SLA.0000000000002926
Herndon, David ; Capek, Karel D. ; Ross, Evan ; Jay, Jayson W. ; Prasai, Anesh ; Ayadi, Amina El ; Foncerrada Ortega, Guillermo ; Blears, Elizabeth ; Sommerhalder, Christian ; McMullen, Kara ; Amtmann, Dagmar ; Cox, Robert ; Hundeshagen, Gabriel ; Jennings, Kristofer ; Sousse, Linda ; Suman, Oscar ; Meyer, Walter ; Finnerty, Celeste. / Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol. In: Annals of Surgery. 2018 ; Vol. 268, No. 3. pp. 431-441.
@article{2b35b19fb8e84f1cbe9e905fb33929e9,
title = "Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol",
abstract = "BACKGROUND: Massive burns induce a hypermetabolic response that leads to total body wasting and impaired physical and psychosocial recovery. The administration of propranolol or oxandrolone positively affects postburn metabolism and growth. The combined administration of oxandrolone and propranolol (OxProp) for 1 year restores growth in children with large burns. Here, we investigated whether the combined administration of OxProp for 1 year would reduce scarring and improve quality of life compared with control.STUDY DESIGN: Children with large burns (n = 480) were enrolled into this institutional review board-approved study; patients were randomized to control (n = 226) or administration of OxProp (n = 126) for 1 year postburn. Assessments were conducted at discharge and 6, 12, and 24 months postburn. Scar biopsies were obtained for histology. Physical scar assessments and patient reported outcome measures of physical and psychosocial function were obtained.RESULTS: Reductions in cellularity, vascular structures, inflammation, and abnormal collagen (P < 0.05) occurred in OxProp-treated scars. With OxProp, scar severity was attenuated and pliability increased (both P < 0.05). Analyses of patient-reported outcomes showed improved general and emotional health within the OxProp-treated group (P < 0.05).CONCLUSIONS: Here, we have shown improvements in objective and subjective measures of scarring and an increase in overall patient-reported physical function. The combined administration of OxProp for up to a year after burn injury should be considered for the reduction of postburn scarring and improvement of long-term psychosocial outcomes in children with massive burns.",
author = "David Herndon and Capek, {Karel D.} and Evan Ross and Jay, {Jayson W.} and Anesh Prasai and Ayadi, {Amina El} and {Foncerrada Ortega}, Guillermo and Elizabeth Blears and Christian Sommerhalder and Kara McMullen and Dagmar Amtmann and Robert Cox and Gabriel Hundeshagen and Kristofer Jennings and Linda Sousse and Oscar Suman and Walter Meyer and Celeste Finnerty",
year = "2018",
month = "9",
day = "1",
doi = "10.1097/SLA.0000000000002926",
language = "English (US)",
volume = "268",
pages = "431--441",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

AU - Herndon, David

AU - Capek, Karel D.

AU - Ross, Evan

AU - Jay, Jayson W.

AU - Prasai, Anesh

AU - Ayadi, Amina El

AU - Foncerrada Ortega, Guillermo

AU - Blears, Elizabeth

AU - Sommerhalder, Christian

AU - McMullen, Kara

AU - Amtmann, Dagmar

AU - Cox, Robert

AU - Hundeshagen, Gabriel

AU - Jennings, Kristofer

AU - Sousse, Linda

AU - Suman, Oscar

AU - Meyer, Walter

AU - Finnerty, Celeste

PY - 2018/9/1

Y1 - 2018/9/1

N2 - BACKGROUND: Massive burns induce a hypermetabolic response that leads to total body wasting and impaired physical and psychosocial recovery. The administration of propranolol or oxandrolone positively affects postburn metabolism and growth. The combined administration of oxandrolone and propranolol (OxProp) for 1 year restores growth in children with large burns. Here, we investigated whether the combined administration of OxProp for 1 year would reduce scarring and improve quality of life compared with control.STUDY DESIGN: Children with large burns (n = 480) were enrolled into this institutional review board-approved study; patients were randomized to control (n = 226) or administration of OxProp (n = 126) for 1 year postburn. Assessments were conducted at discharge and 6, 12, and 24 months postburn. Scar biopsies were obtained for histology. Physical scar assessments and patient reported outcome measures of physical and psychosocial function were obtained.RESULTS: Reductions in cellularity, vascular structures, inflammation, and abnormal collagen (P < 0.05) occurred in OxProp-treated scars. With OxProp, scar severity was attenuated and pliability increased (both P < 0.05). Analyses of patient-reported outcomes showed improved general and emotional health within the OxProp-treated group (P < 0.05).CONCLUSIONS: Here, we have shown improvements in objective and subjective measures of scarring and an increase in overall patient-reported physical function. The combined administration of OxProp for up to a year after burn injury should be considered for the reduction of postburn scarring and improvement of long-term psychosocial outcomes in children with massive burns.

AB - BACKGROUND: Massive burns induce a hypermetabolic response that leads to total body wasting and impaired physical and psychosocial recovery. The administration of propranolol or oxandrolone positively affects postburn metabolism and growth. The combined administration of oxandrolone and propranolol (OxProp) for 1 year restores growth in children with large burns. Here, we investigated whether the combined administration of OxProp for 1 year would reduce scarring and improve quality of life compared with control.STUDY DESIGN: Children with large burns (n = 480) were enrolled into this institutional review board-approved study; patients were randomized to control (n = 226) or administration of OxProp (n = 126) for 1 year postburn. Assessments were conducted at discharge and 6, 12, and 24 months postburn. Scar biopsies were obtained for histology. Physical scar assessments and patient reported outcome measures of physical and psychosocial function were obtained.RESULTS: Reductions in cellularity, vascular structures, inflammation, and abnormal collagen (P < 0.05) occurred in OxProp-treated scars. With OxProp, scar severity was attenuated and pliability increased (both P < 0.05). Analyses of patient-reported outcomes showed improved general and emotional health within the OxProp-treated group (P < 0.05).CONCLUSIONS: Here, we have shown improvements in objective and subjective measures of scarring and an increase in overall patient-reported physical function. The combined administration of OxProp for up to a year after burn injury should be considered for the reduction of postburn scarring and improvement of long-term psychosocial outcomes in children with massive burns.

UR - http://www.scopus.com/inward/record.url?scp=85054096897&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054096897&partnerID=8YFLogxK

U2 - 10.1097/SLA.0000000000002926

DO - 10.1097/SLA.0000000000002926

M3 - Article

VL - 268

SP - 431

EP - 441

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -