[Growth hormone in surgery--an assessment of current knowledge]

The first clinical studies with the application of growth hormone (GH) under postoperative and post-traumatic conditions date back to the early 1960s. The introduction of recombinant human growth hormone made the drug generally available for clinical studies. Administration of GH after elective general surgery improves nitrogen balance. Interruption of the post-traumatic hypermetabolism has been occasionally described, but most studies only demonstrate a slight reduction of the catabolic response. An increasing number of papers report positive influence of GH on wound healing, especially skin graft donor sites. The impact on the immune system has yet to be clarified. This paper gives an comprehensive overview of the current state of knowledge of the clinical effect of GH in various surgical specialties with special respect to septic conditions, burns, trauma, and wound healing.