The Use of Oxandrolone in the Management of Severe Burns: A Multi-service Survey of Burns Centres and Units Across the United Kingdom

Abstract

Introduction Severe thermal burns are a catastrophic injury. Those surviving the initial insult are subject to life-long disability, prolonged hospital admission, nutritional issues and poor wound healing. Oxandrolone has been shown to reduce hospital duration and promote lean body mass. Despite not being licenced for use in burns trauma within the United Kingdom (UK), services across the country utilise Oxandrolone in the management of severe burns. We aim to analyse the use of Oxandrolone in major burns across burns services within the UK. Methods We conducted a survey across all burn centres and units across the UK. Any burns service provider with experience in patient management of patients sustaining burns with a total body surface area >15% was included. All services were identified using the British Burns Association website. We conducted a survey of all centres and units and contacted them via telephone through the trust's switchboard. Responses were accepted from any healthcare staff familiar with the day-to-day in-patient care of patients on the ward. Services with no in-patient services were excluded. Results A total of 24 burns centres and services responded to our survey. Twelve of the respondents were in a burns unit and 12 were in a burns centre. Eight respondents were paediatric facilities, and the remaining 16 dealt with adult burns. In total, 16/24 (66.6%) services reported using Oxandrolone. Conversely, 8/24 (33.3%) burns services denied using Oxandrolone. 7/12 (58.3%) burns units use Oxandrolone in the management of burns. 5/12 (42.7%) burns units do not use Oxandrolone in severe burns. 9/12 (75%) of burns centres described using Oxandrolone, whilst the remaining 3/12 (25%) did not. Discussion Oxandrolone is used varyingly across burns services across the UK. Burns centres were more likely to use Oxandrolone compared to units. We also find that more paediatric services used Oxandrolone in comparison to adult services. Studies have shown that the benefit of Oxandrolone is not age-dependent. Further work is required to assess the impact of this medication on patients with severe burns and national guidance would help further improve burns management across the UK.

Keywords: burns; critical care; oxandrolone; plastics; steroids.

Figure 1. Flowchart detailing the process of data collection within the study.

Forty-two burns services were identified from the British Burns Association website. Seven burns facilities were excluded as these services do not deal with acute major in patient burns. Thirty-five burns centres and units were called up to three times. A total of 24 burns units and centres responded across the United Kingdom.

Figure 2. Map of the UK with the included burns services responding to our survey.

Figure 3. Pie chart detailing the staff roles of responders within our survey of all burns centres and units across the UK.

Figure 4. Graph detailing the number of responses depending on the type of burns service and whether they use Oxandrolone.

Figure 5. Column chart showing the use of Oxandrolone depending on the level of facility and subset of patients.

Figure 6. Questionnaire filled out by the authors of the study to collate information about Oxandrolone use across burns services within the UK.