Oxandrolone use in adult burn patients. Systematic review and meta-analysis

Abstract

PURPOSE:This study is a systematic literature review and meta-analysis concerning the use of a testosterone synthetic analog, oxandrolone, and its use in severe adult burns. METHODS:Randomized prospective clinical studies, in English, Portuguese or Spanish, were sought on the following databases:MEDLINE, COCHRANE, EMBASE and LILACS. There was no restriction in relation to the publication date. RESULTS:This search produced 24 studies on MEDLINE and twelve articles were presented on the COCHRANE database .Sixteen were excluded due to the title not being related to this search or by including children. Of the eigth residual studies, after adaptation to the inclusion criteria, only four were selected. After analyzing the results, two were discarded since they did not present adequate patient characterization and the facts on these articles were analyzed differently from the others, hindering the meta-analysis. CONCLUSION:The analysis of the available data demonstrated significant benefits (p<0.05) considering lesser loss of corporal mass, lesser nitrogen loss, and shorter donor area healing time, when Oxandrolone was used, comparatively with the control group (placebo or not).

Burns

“…86 Yet, many centers still refrain from the use of oxandrolone due to previously reported risks not observed in this study. 86 As is the case with many topics related to management of burns, the meta-analysis strongly encouraged a randomized, double blind study, with a larger number of patients to obtain quality evidence for the testosterone analog.…”

“…86 As is the case with many topics related to management of burns, the meta-analysis strongly encouraged a randomized, double blind study, with a larger number of patients to obtain quality evidence for the testosterone analog. 86 Yet, with some institutions already empirically treating patients with oxandrolone before initiation of a clinical trial, a prospective trial to evaluate the effectiveness of the drug has yet to occur.…”

“…90 Although MSCs with self-renewable and multipotential properties provide a vital modality of repair and regeneration, their vitality varies according to the donor age and health condition. 75,85,86 Research in recent years has suggested that umbilical cord-derived MSCs exhibit higher occurrence of colony-forming unit fibroblast than bone marrow-derived MSCs, suggesting more primitive features. 75 …”

Burn Care in a General Hospital in the City of São Carlos, Brazil: Active Learning Methodology

“…According to recommended advices for the initial care of the burn victim patient, the initial measures aim at the clinical stabilization of the patient and the simple coverage of the wounds with dry and sterile dressings allied to the treatment for pain and transfer of the patient to specialized care within the first 24 hours after clinical stabilization [8,18].…”

“…After initiation of specialized care based on the current protocols recommended [6][7][8][9][10][11][12][13][14][15]18], under the guidance of a specialist in plastic practical participation of the students. The formulations of hypotheses and questions served to fill the knowledge gaps encountered.…”