Table 148

Wound Healing Effects of Human Growth Hormone

Increases re-epithelialization rate of donor sites Increases wound collagen content Increases granulation tissue Increases wound tensile strength

Complications

Significant complications can occur with the use of HGH. The anti-insulin effects are problematic in that glucose is less efficiently used for fuel, and increased plasma glucose levels are known to be deleterious.

Increased insulin requirements occur. Complications are listed in Table 14.9.58,59 It is important to also point out the findings of a multicenter European study of critically ill patients receiving HGH. In this study of critically ill postoperative cardiac patients, mortality was twofold greater in those treated with HGH compared to placebo.58

Summary

In summary, use of HGH in conjunction with adequate nutrition and protein intake clearly results in increased anabolic activity and will positively impact wound healing by increasing protein synthesis in catabolic populations. There are some data that indicate that HGH can directly improve wound healing. However, the impact of IGF-1 and insulin on the effects of HGH remains undefined.

insulin-like growth factor (igf-1)

Actions

Insulin-like growth factor-1 (IGF-1) is a large polypeptide that has hormone-like properties.60-64 The IGF-1, also known as somatomedin-C, has metabolic and anabolic properties similar to insulin.

Although produced by a variety of wound cells, such as fibroblasts and platelets, the main source is the liver, where IGF synthesis is initiated by HGH. The IGF

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