Document Detail


Intensive insulin treatment increases donor site wound protein synthesis in burn patients.
MedLine Citation:
PMID:  21236451     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Demidmaa Tuvdendorj; Xiao-Jun Zhang; David L Chinkes; Asle Aarsland; Gabriela A Kulp; Marc G Jeschke; David N Herndon
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-01-14
Journal Detail:
Title:  Surgery     Volume:  149     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-16     Completed Date:  2011-06-01     Revised Date:  2011-10-14    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  512-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Affiliation:
Metabolism Unit, Shriners Hospital for Children, Galveston, TX 77550-1220, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Burns / surgery
Child
Child, Preschool
Female
Humans
Hypoglycemic Agents / administration & dosage*
Insulin / administration & dosage*
Male
Protein Biosynthesis / drug effects*
Skin Transplantation*
Wound Healing / drug effects*
Grant Support
ID/Acronym/Agency:
H133A020102//PHS HHS; P50-GM60338/GM/NIGMS NIH HHS; R01 GM056687-13/GM/NIGMS NIH HHS; R01-GM56687/GM/NIGMS NIH HHS; T32-GM08256/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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