Table 1421

Clinical Effect of Anabolic Steroids

Attenuate the catabolic stimulus during the "stress response" More rapid restoration of lost lean mass Restore normal nutrient partitioning

Improved healing of chronic wounds with restoration of lost lean mass clinical value. Oxandrolone is given orally, with 99% bioavailability. It is protein bound in plasma with a biologic life of 9 h.

The anabolic steroids, especially oxandrolone, have been successfully used in the trauma and burn patient population to both decrease lean mass loss in the acute phase of injury as well as more rapidly restore lost lean mass in the recovery phase.37-41117-121 A significant attenuation of catabolism and increase in lean mass, has also been reported with HIV infection, in the COPD population, and spinal cord injury population.117-121 Demonstrated in several studies is an increase in the healing of chronic wounds. However, significant lean mass gains were also present.

It is important to point out that in all of the clinical trials where lean mass gains were reported, a high-protein diet was used. In most studies, a protein intake of 1.2 to 1.5 g/kg/d was used, 0.8 g/kg/day.

Wound Healing Properties

The effects of anabolic steroids on wound healing appear to be, in large part, due to a general stimulation of overall anabolic activity. However, there is increasing evidence of a direct stimulation of all phases of wound healing by these agents122-128 (Table 14.22 and Table 14.23).

Falanga et al.124 reported a stimulation of collagen synthesis with the anabolic steroid stanazol. Erlich et al.125 reported a tenfold increase in the messenger RNA for collagen synthesis, in a human fibroblast culture with oxandrolone. Tenenbaum et al.126 reported increased synthesis of bone, collagen, matrix, and epidermis in a wound of the oral cavity stimulated with oxandrolone. Demling116 reported a marked increase in the healing of a cutaneous wound in the rat treated with oxandrolone compared to controls. A 50% increase in wound collagen was noted as well as a doubling of tensile strength at 3 weeks with oxandrolone. Histology also revealed

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