[Mechanisms of skeletal muscle wasting after severe burn and its treatment]

Most of the major advances in burn treatment were made within the last five decades. However, hypermetabolic response after severe burn remains a problem in the treatment of patients with massive burn. As skeletal muscle accounts for over 50% of body cell dry weight, its catabolism exerts profound effect on body metabolism as a whole. Main mechanisms underlying skeletal muscle wasting induced by severe burn include activation of ubiquitin-proteasome pathway, bringing about breakdown of muscle protein, and myonuclear apoptosis. Therapeutic strategies for skeletal muscle wasting after burn mainly include maintenance of room temperature at (31.5 +/- 0.7) degrees C, early active and passive exercise of skeletal muscles, administration of beta adrenergic receptor blocker such as Propranolol, recombinant growth hormone, androgen, and insulin, which has lately been proven to possess the effect of suppressing myonuclear apoptosis after burn. Combination of multiple therapeutic strategies is beneficial in reducing complications of burn patients, particularly wide ranged skeletal muscle atrophy, to achieve a better clinical outcome.