The Influence of Systemic Growth Hormone Administration on the Healing Time of Skin Graft Donor Sites in a Pig Model

Abstract

A more rapid healing of skin graft donor sites has often been observed during ultimoratio therapies with growth hormone in adults who have suffered extremely severe burns. The purpose of this animal experimental study was to examine the influence of systemic growth hormone administration on the healing time of skin graft donor sites under standardized conditions in pigs. The animals were 14 (7 experimental and 7 control) male, sexually mature, German domestic pigs, in which 30 skin graft donor sites 8 cm x 4 cm and 0.6 mm deep were created. Fifteen each of the skin graft donor sites were bandaged with the same material [hydrocolloid bandage (Varihaesive E) and PVP-iodine gauze (Braunovidon Gaze)]. The test period was 15 days for each pig, whereby recombinant growth hormone (0.5 IU/kg body weight per day) was applied subcutaneously in the experimental group. The bandages were changed under brief narcosis every 2 days, during which one skin-punch biopsy was taken per skin graft donor site, and blood samples were drawn for determination of the serum IGF-1 values. Photographic documentation was also recorded. The biopsies were examined histologically (hematoxylin and eosin stain) and immunohistochemically (collagen IV and VII, and laminin), whereby histologically the start of keratinization was assessed as a healing criterion. The serum IGF-1 values in the growth hormone group were statistically significantly higher than in the control group. Immunohistochemically, a complete basal membrane was observed in both the experimental and the control group after the 7th or 8th day. A clearly elevated serum IGF-1 level correlated in the growth hormone group with the skin graft donor sites healing. It could thus be demonstrated both clinically and histologically that systemic application of growth hormone results in a statistically significantly more rapid healing of the skin graft donor sites by 2 days earlier than in the control group.

Growth Hormone (GH) and Wound Healing

“…Key points about evidence of GH and wound healing. Growth Hormone (GH) and Wound Healing http://dx.doi.org/10.5772/intechopen.80978 Wound Healing -Current Perspectives that systemic GH administration could accelerate the split-thickness skin defect in pigs [7]. However, systemic use of GH may induce side effects that must be considered when using this way.…”

“…(5) SOCS are expressed after GHR translocation to the nucleus of the cell, and they act by inhibiting GH signaling, directly or affecting the translocation of the GHR to the nucleus. (6, 7) Cells may express GH that acts in an autocrine (6) or paracrine (7) manner. This cellular production of the hormone may lead to an interaction with the membrane GHR (8) impeding the effects of endocrine, or exogenously administered hormone, or topically applied; these auto/paracrine GHs even may produce the desensitization of GHR, therefore impeding GH actions at this level.…”

“…We currently know that growth hormone (GH) is a pleiotropic factor capable of acting positively in many organs and tissues. For years, the use of GH for wound healing has been investigated [6,7]. For example, the use of recombinant human GH as an anabolic treatment in burns to accelerate wound healing is already classic [8,9].…”

An Alternative Method to Minimize Pain in the Split-Thickness Skin Graft Donor Site

“…There are reports on accelerated healing with the use of growth hormone through an insulin-like growth factor-1-mediated mechanism, but the exact mechanism is still not clear. 42,43 Epidermal growth factor use has also been a matter of debate. Unfortunately, patient comfort and donor-site healing were not discussed thoroughly in these reports.…”

Hormone Modulation, Low Glycemic Nutrition, and Exercise Instruction: Effects on Disease Risk and Quality of Life

“…46 Growth hormone deficiency (GHD) is associated with the following, all of which can be significantly reversed with replacement of human growth hormone (G): a decrease in lean Cenegenics ® Medical Institute, Las Vegas, Nevada. body mass, [47][48][49][50][51] bone density, 52-58 skin thickness, 59 sense of well-being, 60-65 rate of wound healing, [66][67][68][69][70] immune responsiveness, 71,72 and aerobic capacity. 73,74 In addition, GHD is associated with an increase in the following, all of which have been reduced in clinical trials of G: (LDL), 75 atherosclerosis, 65,[76][77][78][79][80][81][82] total body fat, [47][48][49][50][51] hospitalization rate and sick days from work.…”