[Growth hormone and surgery].

Development of biosynthetic human growth hormone (b-hGH) may be a beneficial supplement in the treatment of surgical patients with major traumas in future. As a result of its anabolic actions, b-hGH has proved to be protein conserving in patients who have undergone major gastrointestinal operations with a net decrease in urinary protein excretion, increased fat oxidation and preservation of grip strength and lean body mass. In addition, animal experiments have shown a pronounced stimulatory effect on the healing of tibial fractures in both young and old rats and in the healing of colon anastomoses, as evaluated from the biomechanical properties of the tissues. Experimental skin wounds have also been shown to benefit from b-hGH treatment but only in the early phases of the healing process. Studies on woundhealing in humans have revealed beneficial effects of b-hGH on donor-site healing in skin grafting of patients with severe burns on systemic administration and on healing of chronic leg ulcers on topical application. Further studies in humans with characterization of patients who may benefit from the treatment and the dose-response relations are required to evaluate possible employment of growth hormone in surgical practice.