Efficacy of propranolol in wound healing for hospitalized burn patients

Burn patients have the highest metabolic rate among critically ill or injured patients. Because propranolol decreases energy expenditure and muscle protein catabolism, in this study, we hypothesized that propranolol would improve healing process and decrease wound-healing time. This study was a double-blind randomized clinical trial; a total of 79 burn patients who referred to this center from January 2006 to January 2007 fulfilled the inclusion criteria. Thirty-seven patients were randomly placed in propranolol group and 42 in control group. The propranolol group received propranolol orally with the dose of 1 mg/kg/d and maximum dose of 1.98 mg/kg/d given in six divided doses. This dose was adjusted to decrease the resting heart rate by 20% from each patient's baseline value. The control group received placebo. The most common cause of burn in both groups was flame followed by flash. Patients with superficial burns in the propranolol group needed less time to heal for acceptable wound healing in superficial burns (16.13+/-7.40 days vs 21.52+/-7.94 days; P=.004). We also found that patients with deep burn injury needed less time to be ready for skin graft (28.23+/-8.43 days vs 33.46+/-9.17 days; P=.007) when compared to that of the control group. The use of propranolol decreased the size of the burn wound that finally needed skin graft. Patients in the propranolol group with an average burn size of 31.42% TBSA finally needed 13.75% of TBSA skin graft compared with that of control patients with an average burn size of 33.61% TBSA who needed 18.72% of TBSA skin graft, and patients in the control group with an average burn size of 33.61% TBSA finally needed 18.72% of TBSA skin graft (P=.006). Patients in the propranolol group had a shorter hospital stay period than the control group (30.95+/-8.44 days vs 24.41+/-8.11 days; P=.05). Administration of propranolol, improved burn wound healing, and decreased healing time and hospital stay period. The use of propranolol decreased the surface area of wounds that needed to be skin grafted.