Skip to main content

Effect of Growth Hormone Administration on Colonic Healing and Repair

  • Chapter
Book cover Growth Factors and Wound Healing

Part of the book series: Serono Symposia USA Norwell, Massachusetts ((SERONOSYMP))

  • 348 Accesses

Abstract

The understanding of anastomotic healing and wound management is fundamental in surgery because leakage of a colorectal anastomosis increases threefold the postoperative morbidity and remains the most important mortality factor in gastrointestinal surgery (1, 2). Rates of clinically manifest leaks of colonic anastomoses have been reported to reach 14%, and x-ray inspection of extraperitoneal anastomoses has revealed leakage rates of up to 51% (3, 4).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Schrock TR, Deveney CW, Dunphy JE. Factors contributing to leakage of colonic anastomoses. Ann Surg 1973;177:513–8.

    Article  PubMed  CAS  Google Scholar 

  2. Fielding LP, Steward-Brown S, Blesovsky L, Kearney G. Anastomotic integrity after operations for large-bowel cancer: a multicenter study. Br Med J 1980;281:411–4.

    Article  PubMed  CAS  Google Scholar 

  3. Turunen MJ, Peltakallio P. Surgical results in 657 patients with colorectal cancer. Dis Colon Rectum 1983;26:606–12.

    Article  PubMed  CAS  Google Scholar 

  4. Goligher JC, Graham NG, De Dombal FT. Anastomatic dehiscence after anterior resection of rectum and sigmoid. Br J Surg 1970;57:109–18.

    Article  PubMed  CAS  Google Scholar 

  5. Cuthbertson DP. Observations on the disturbance of metabolism produced by injury to the limbs. Q J Med 1931;2:233–46.

    Google Scholar 

  6. Douglas RG, Shaw JHF. Metabolic response to sepsis and trauma. Br J Surg 1989;76:115–22.

    Article  PubMed  CAS  Google Scholar 

  7. Ross RJM, Miell JP. Avoiding autocannibalism. Consider growth hormone and insulin-like growth factor I. Br Med J 1991;303:1147–8.

    Article  CAS  Google Scholar 

  8. Ward HC, Halliday D, Sim AJW. Protein and energy metabolism with biosynthetic human growth hormone after gastrointestinal surgery. Ann Surg 1987;206:56–60.

    Article  PubMed  CAS  Google Scholar 

  9. Ponting GA, Halliday D, Teale JD, Sim AJW. Postoperative positive nitrogen balance with intravenous hyponutrition and growth hormone. Lancet 1988;438–9.

    Google Scholar 

  10. Jiang ZM, He GZ, Zhang SY. Low-dose growth hormone and hypocaloric nutrition attenuate the protein-caloric response after major operation. Ann Surg 1989;210:513–25.

    Article  PubMed  CAS  Google Scholar 

  11. Douglas RG, Humberstone DA, Heystead A. Metabolic effects of recombinant human growth hormone: isotopic studies in the postabsorptive state and during parenteral nutrition. Br J Surg 1990;77:785–90.

    Article  PubMed  CAS  Google Scholar 

  12. Koea JB, Douglas RG, Shaw JHF, Gluckman PD. Growth hormone therapy initiated before starvation ameliorates the catabolic state and enhances the protein-sparing effect of total parenteral nutrition. Br J Surg 1993;80:740–4.

    Article  PubMed  CAS  Google Scholar 

  13. Pessa ME, Bland KI, Copeland III EM. Growth factors and determinants of wound repair. J Surg Res 1987;42:207–17.

    Article  PubMed  CAS  Google Scholar 

  14. Johnson LR. Regulation of gastrointestinal growth. In: Johnson LR, ed. Physiology of the gastrointestinal tract. New York: Raven Press, 1987:301–3.

    Google Scholar 

  15. Burgess AW, Sizeland AM. Growth factors and the gut. J Gastroenterol Hepatol 1990;5:10–21.

    Article  PubMed  Google Scholar 

  16. Lemoine NR, Leung HY, Gullick WJ. Growth factors in the gastrointestinal tract. Gut 1992;33:1297–300.

    Article  PubMed  CAS  Google Scholar 

  17. Playford RJ, Woodman AC, Clark P, et al. Effect of luminal growth factor preservation on intestinal growth. Lancet 1993;341:843–8.

    Article  PubMed  CAS  Google Scholar 

  18. Sakata T, Engelhardt WV. Stimulatory effect of short chain fatty acids on the epithelial cell proliferation in rat large intestina. Comp Biochem Physiol 1983;74:459–62.

    Article  CAS  Google Scholar 

  19. Stragand JJ, Hagemann RF. Effect of lumenal contents on colonic replacement. Am J Physiol 1977;233:E208–11.

    PubMed  CAS  Google Scholar 

  20. Lund PK, Ulshen MH, Rountree DB, Selub SE, Buchan AM. Molecular biology of gastrointestinal peptides and growth factors: relevance to intestinal adaptation. Digestion 1990;46:66–73.

    Article  PubMed  CAS  Google Scholar 

  21. Rouiller D, Schusdziarra V, Conlon JM, Harris V, Unger RH. Release of somatostatin-like immunoreactivity from the lower gut. Gastroenterology 1979;77:700–3.

    PubMed  CAS  Google Scholar 

  22. Denef C, Schramme C, Baes M. Stimulation of growth hormone release by vasoactive intestinal peptide and peptide PHI in rat anterior pituitary reaggregates. Neuroendocrinology 1985;40:88–91.

    Article  PubMed  CAS  Google Scholar 

  23. Wehrenberg WB, Janowski BA, Piering AW, Culler F, Jones KL. Glucocorticoids: potent inhibitors and stimulators of growth hormone secretion. Endocrinology 1990;126:3200–3.

    Article  PubMed  CAS  Google Scholar 

  24. Leblond CP, Carriere R. The effect of growth hormone and thyroxine on the mitotic rate of the intestinal mucosa of the rat. Endocrinology 1955;56:261–6.

    Article  PubMed  CAS  Google Scholar 

  25. Havivi Y, Havivi E, Levitan R. Histology and chemical composition of the small bowel of hypophysectomized rats. Am J Dig Dis 1968;13:735–42.

    Article  PubMed  CAS  Google Scholar 

  26. Schapiro H, Wruble LD, Brott LG. The effect of hypophysectomy on the gastrointestinal tract. Digest Dis 1970;15:1019–30.

    Article  CAS  Google Scholar 

  27. Scow RO, Hagan SN. Effect of testosterone propionate and growth hormone on growth and chemical composition of muscle and other tissues in hypophysectomized male rats. Endocrinology 1965;77:852–8.

    Article  PubMed  CAS  Google Scholar 

  28. Jacobsen ED, Magnani TJ. Some effects of hypophysectomy on gastrointestinal function and structure. Gut 1964;5:473–9.

    Article  Google Scholar 

  29. Dowling RH, Fuller R, Ulshen MH, Zimmermann E, Kay Lund P. Small and large bowel mRNA in the intestinal adaption of growth hormone transgenic mice. Gut 1991;32:1208 (abstr).

    Google Scholar 

  30. Ulshen MH, Dowling RH, Fuller CR, Zimmermann EM, Lund PK. Enhanced growth of small bowel in transgenic mice overexpressing bovine growth hormone. Gastroenterology 1993;104:973–80.

    PubMed  CAS  Google Scholar 

  31. Mainoya JR. Influence of ovine growth hormone on water and NaCl transport by the rat proximal jejunum and distal ileum. Comp Biochem Physiol 1982;71A:477–9.

    Article  CAS  Google Scholar 

  32. Bruns MEH, Volmer SS, Bruns DE, Overpeck JG. Human growth hormone increases intestinal vitamin D-dependent calcium binding proteins in hypophysectomized rats. Endocrinology 1983;113:1387–92.

    Article  PubMed  CAS  Google Scholar 

  33. Finkelstein JD, Schacter D. Active transport of calcium by intestine: effects of hypophysectomy and growth hormone. Am J Physiol 1962;203:873.

    CAS  Google Scholar 

  34. Enochs MR, Johnson LR. Effect of hypophysectomy and growth hormone on serum and antral gastrin levels in the rat. Endocrinology 1976;70:727–32.

    CAS  Google Scholar 

  35. Daughaday WH. Growth hormone and the somatomedins. In: Daughaday WH, ed. Endocrine control of growth. New York: Elsevier, 1981:1–24.

    Google Scholar 

  36. Laburthe M, Rouyer-Fessard C, Gammeltoft S. Receptors for insulin-like growth factors I and II in rat gastrointestinal epithelium. Am J Physiol 1988;254:G457–62.

    PubMed  CAS  Google Scholar 

  37. Lemmey AB, Martin AA, Read LC, Tomas FM, Owens PC, Ballard FJ. IGF-I and the truncated analogue des-(1–3)IGF-I enhance growth in rats after gut resection. Am J Physiol 1991;260:E213–19.

    PubMed  CAS  Google Scholar 

  38. Salub SF, Ulshen MH, Lund PK. IGF-I mRNA disruption in rat gastrointestinal tract and growth hormone dependent expression. Abstract, Digestive Disease Week, New Orleans, May 19–22, 1991.

    Google Scholar 

  39. Kostyo JI, Isakson O. Growth hormone and regulation of somatic growth. In Int Rev Physiol Reprod Physiol 1977;13:255–74.

    CAS  Google Scholar 

  40. Isaksson OGP, Edén S, Jansson JO. Mode of actoin of pituitary growth hormone on target cells. Annu Rev Physiol 1985;47:483–99.

    Article  PubMed  CAS  Google Scholar 

  41. Lobie PE, Briepohl W, Waters MJ. Growth hormone receptor expression in the rat gastrointestinal tract. Endocrinology 1990;126:299–306.

    Article  PubMed  CAS  Google Scholar 

  42. Mjaaland M, Unneberg K, Jenssen TG, Reuhaug A. Experimental study to show that GH treatment before trauma increases glutamine uptake in the intestinal tract. Br J Surg 1995;82:1076–79.

    Article  PubMed  CAS  Google Scholar 

  43. Clemmons DR, Shaw PS. Purification and biologic properties of fibroblast somatomedin. J Biol Chem 1986;261:10294–8.

    Google Scholar 

  44. Martens MFWC, Hendriks T. Collagen synthesis in explants from rat intestine. Biochem Biophys Acta 1989;993:252–8.

    Article  PubMed  CAS  Google Scholar 

  45. Brasken P, Lehto M, Renvall S. Fibronectin, laminin, and collagen types I, III, IV and V in the healing rat colon anastomosis. Ann Chir Gynecol 1990;79:65–71.

    CAS  Google Scholar 

  46. Larrey J, Recueil de memoires de chirurgie (1821). Translated by John Revere. Baltimore, MD: 1823.

    Google Scholar 

  47. Prudden JF, Nishihara G, Ocampo L. The effect on wound tensile strength of marked postoperative anabolism induced with growth hormone. Surg Gynecol Obstet 1958;106:481–2.

    Google Scholar 

  48. Kowalewski K, Yong S. Effect of growth hormone and an anabolic steroid on hydroxyproline in healing dermal wounds in rats. Acta Endocrinol (Copenh) 1968;59:53–6.

    CAS  Google Scholar 

  49. Meffert W, Liebow AA. Hormonal control of collateral circulation. Circ Res 1966;18:228–33.

    Article  CAS  Google Scholar 

  50. Hollander DM, Devereux DF, Marafino BJ, Hoppe H. Increased wound breaking strength in rats following treatment with synthetic human growth hormone. Surg Forum 1984;35:612–4.

    CAS  Google Scholar 

  51. Pessa ME, Bland KI, Sitren HS, Miller GJ, Copeland EM. Improved wound healing in tumor-bearing rats treated with perioperative synthetic human growth hormone. Surg Forum 1985;36:6–8.

    CAS  Google Scholar 

  52. Jørgensen PH, Andreassen TT. Influence of biosynthetic human growth hormone on the biochemical properties of rat skin incisional wounds. Acta Chir Scand 1988;154:623–6.

    PubMed  Google Scholar 

  53. Bak B, Jørgensen PH, Andreassen TT. The stimulating effect of growth hormone on fracture healing is dependent on onset and duration of administration. Clin Orthop 1991;264:295–301.

    PubMed  Google Scholar 

  54. Jørgensen PH, Andreassen TT. A dose-response study of the effects of biosynthetic human growth hormone on formation and strength of granulation tissue. Endocrinology 1987;121:1637–41.

    Article  PubMed  Google Scholar 

  55. Hart MH, Phares CK, Erdman SH, Grandjean CJ, Park JHY, Vanderhoof JA. Augmentation of postresectional mucosal hyperplasia by plerocercoid growth factor (PGF). Analog of growth hormone. Dig Dis Sci 1987; 32:1275–80.

    Article  PubMed  CAS  Google Scholar 

  56. Herndon DN, Barrow RE, Kunkel KR, Broemeling L, Rutan RL. Effects of recombinant human growth hormone on donor-site healing in severely burned children. Ann Surg 1990;212:424–31.

    Article  PubMed  CAS  Google Scholar 

  57. Chlumsky V. Experimentelle Untersuchungen über dir verschiedenen Methoden der Darmvereinigung. Bruns’ Beiträge zur Klinisch Chirurgie 1989; 25:539–600.

    Google Scholar 

  58. Peacock EE. Wound repair, 3rd ed. Philadelphia: W.B. Saunders, 1984.

    Google Scholar 

  59. Nelsen TS, Anders CJ. Dynamic aspects of small intestinal rupture with special considerations of anastomotic strength. ARch Surg 1966;93:309–14.

    Article  PubMed  CAS  Google Scholar 

  60. Christensen H, Langfeldt S, Laurberg S. Bursting strength of experimental intestinal anastomoses. A methodological study. Eur Surg Res 1993;25:38–45.

    Article  PubMed  CAS  Google Scholar 

  61. Gottrup F. Healing of incisional wounds in the stomach and duodenum. An experimental study. Thesis, University of Aarhus, 1983.

    Google Scholar 

  62. Christensen H, Oxlund H, Laurberg S. Growth hormone increases the bursting strength of colonic anastomoses. An experimental study in the rat. Int J Color Dis 1990;5:130–4.

    Article  CAS  Google Scholar 

  63. Christensen H, Oxlund H, Laurberg S. Postoperative biosynthetic human growth hormone increases the strength and collagen deposition of experimental colonic anastomoses. Int J Color Dis 1991;6:133–8.

    Article  CAS  Google Scholar 

  64. Edén S. Age-and sex-related differences in episodic growth hormone secretion in the rat. Endocrinology 1979;105:555–60.

    Article  PubMed  Google Scholar 

  65. Christensen H, Flyvbjerg A. Dose-dependent effect of human growth hormone on the strength and collagen deposition of colonic anastomoses in rats. Acta Endocrinol (Copenh) 1992;126:438–43.

    CAS  Google Scholar 

  66. Christensen H, Oxlund H. Growth hormone increases the collagen deposition rate and breaking strength of left colonic anastomoses in rats. Surgery 1994;116:550–6.

    PubMed  CAS  Google Scholar 

  67. Christen H, Jørgensen PH, Oxlund H, Laurberg S. Growth hormone increases the mass, the collagenous proteins, and the strength of rat colon. Scand J Gastroenterol 1990;25:1137–43.

    Article  Google Scholar 

  68. Jiborn H. Healing of left colonic anastomoses. An experimental study in the rat. Thesis, University of Lund, Malmö, 1978.

    Google Scholar 

  69. Hendriks T, Mastboom WJB. Healing of experimental intestinal anastomoses. Parameters for repair. Dis Colon Rectum 1990;33:891–901.

    Article  PubMed  CAS  Google Scholar 

  70. Stappen JWJ, Hendriks T, Boer HHM, Man BM, Pont JJHHM. Collagenolytic activity in experimental intestinal anastomoses. Int J Color Dis 1992;7: 95–101.

    Article  Google Scholar 

  71. Delbridge L, Everitt AV. The effect of hypophysectomy and age on the stabilization of labile cross-links in collagen. Exp Gerontol 1972;7:413–5.

    Article  PubMed  CAS  Google Scholar 

  72. Oxlund H, Jørgensen PH, Ørtoft G, Andreassen TT. Alterations in the cross-links of skin collagen of rats treated with biosynthetic human growth hormone. Connect Tissue Res 1991;26:65–75.

    Article  PubMed  CAS  Google Scholar 

  73. Christensen H, Andreassen TT, Oxlund H. Increased mechanical strength of left colon in old rats treated with biosynthetic growth hormone. Gerontology 1992;38:245–51.

    Article  PubMed  CAS  Google Scholar 

  74. Chowcat NL, Savage FJ, Hembry RM, Boulos PB. Role of collagenase in colonic anastomoses: a reappraisal. Br J Surg 1988;75:330–4.

    Article  PubMed  CAS  Google Scholar 

  75. Houdart R, Lavergne A, Galian A, Hautefeuille P. Évolution anatomopathologique des anastomoses digestives bord a bord en un plan. Gastroenterol Clin Biol 1983;7:465–73.

    PubMed  CAS  Google Scholar 

  76. Christensen H, Chemnitz J, Christensen BC, Oxlund H. Collagen structural organisation of healing colonic anastomoses and the effect of growth hormone treatment. Dis Colon Rectum 1995; in press.

    Google Scholar 

  77. Konturek SJ, Król R, Pawlik W, et al. Pharmacology of somatostatin. In: Bloom SR, ed. Gut hormones. Edinburgh: Churchill Livingstone, 1978:457–62.

    Google Scholar 

  78. Leyden T, Rosenberg J, Nemchausky B, Elson C, Rosenberg I. Reversal of growth arrest in adolescents with Crohn’s disease after parenteral alimentation. Gastroenterology 1976;70:1017–21.

    Google Scholar 

  79. Underwood LE, Clemmons DR, Maes M, D’Ercole AJ, Ketelslegers J-M. Regulation of somatomedin C/insulin-like growth factor I by nutrients. Horm Res 1986;24:166–76.

    Article  PubMed  CAS  Google Scholar 

  80. Hawker FH, Steward PM, Baxter RC, et al. Relationship of somatomedinC/insulin-like growth factor I levels to conventional nutritional indices in critically ill patients. Crit Care Med 1987;15:732–6.

    Article  PubMed  CAS  Google Scholar 

  81. Morris GP, Beck PL, Herridge MS, Depew WT, Szewczuk MR, Wallace JL. Hapten-induced model of chronic inflammation and ulceration in the rat colon. Gastroenterology 1989;96:795–803.

    PubMed  CAS  Google Scholar 

  82. Krawisz JE, Sharon P, Stenson WF. Quantitative assay for acute intestinal inflammation based on myeloperoxidase activity. Gastroenterology 1984; 87:1344–50.

    PubMed  CAS  Google Scholar 

  83. Christensen H, Flyvbjerg A, Ørskov H, Laurberg S. Effect of growth hormone on the inflammatory activity of experimental colitis in rats. Scand J Gastroenterol 1993;28:503-I1.

    Article  PubMed  CAS  Google Scholar 

  84. Alexander AC, Irving MH. Accumulation and pepsin solubility of collagens in the bowel of patients with Crohn’s disease. Dis Colon Rectum 1990;33:956–62.

    Article  PubMed  CAS  Google Scholar 

  85. Durdey P, Switala S, Williams NS. Collagenolytic activity in Crohn’s colitis. Br J Surg 1987;74:527.

    Google Scholar 

  86. Thissen JP, Underwood LE, Maiter D, Maes M, Clemmons DR, Ketelslegers JM. Failure of insulin-like growth factor-I (IGF-I) infusion to promote growth in protein-restricted rats despite normalization of serum IGF-I concentrations. Endocrinology 1991;128:885–90.

    Article  PubMed  CAS  Google Scholar 

  87. Kissmeyer-Nielsen P, Christensen H, Laurberg S. Growth hormone treatment of rats with chronic diverting colostomy. Different response on proximal functioning and distal atrophic colon. Eur J Endocrinol 1994;130:508–14.

    Article  PubMed  CAS  Google Scholar 

  88. Christensen H, Oxlund H, Laurberg S. Stimulating effect of biosynthetic human growth hormone on adult rat colon. Gastroenterol Int 1991;4:65–9.

    Google Scholar 

  89. Irvin TT. Effects of malnutrition and hyperalimentation on wound healing. Surg Gynecol Obstet 1978;146:33–7.

    PubMed  CAS  Google Scholar 

  90. Spanheimer R, Zlatev T, Umpierrez G, DiGirolamo M. Collagen production in fasted and food-restricted rats: response to duration and severity of food-deprivation. J Nutr 1991;121:518–24.

    PubMed  CAS  Google Scholar 

  91. Ziegler TR, Young LS, Manson JM, Wilmore DW. Metabolic effects of recombinant human growth hormone in patients receiving parenteral nutrition. Ann Surg 1988;208:6–16.

    Article  PubMed  CAS  Google Scholar 

  92. Zaizen Y, Ford EG, Costin G, Atkinson JB. The effect of perioperative exogenous growth hormone on wound bursting strength in normal and malnourished rats. J Pediatr Surg 1990;25:70–4.

    Article  PubMed  CAS  Google Scholar 

  93. Kelts DG, Grand RJ, Shen G, Watkins JB, Werlin SL, Boehme C. Nutritional basis of growth failure in children and adolescents with Crohn’s disease. Gastroenterology 1979;76:720–7.

    PubMed  CAS  Google Scholar 

  94. Desborough JP, Griffin RA, Moore CM, Burrin JM, Hall GM. Growth hormone secretion in response to surgery. Horm Metab Res 1993;25:640–3.

    Article  PubMed  CAS  Google Scholar 

  95. Manson J, Wilmore DW. Growth hormone in the surgical patient. In: Underwood LE, ed. Growth hormone. New York: Marcel Dekker, 1986:255–67.

    Google Scholar 

  96. Wright PD, Johnston IDA. The effect of surgical operation on growth hormone levels in plasma. Surgery 1975;77:479–86.

    PubMed  CAS  Google Scholar 

  97. Arimura A, Smith WD, Schally AV. Blockade of the stress-induced decrease in blood GH by anti-somatostatin serum in rats. Endocrinology 1976;98:540–43.

    Article  PubMed  CAS  Google Scholar 

  98. Kupfer SR, Underwood LE, Baxter RC, Clemmons DR. Enhancement of the anabolic effects of growth hormone and insulin-like growth factor I by use of both agents simultaneously. J Clin Invest 1993;91:391–96.

    Article  PubMed  CAS  Google Scholar 

  99. Ng E-H, Rock CS, Lazarus D, et al. Impact of exogenous growth hormone on host preservation and tumor cell-cycle distribution in a rat sarcoma model. J Surg Res 1991;51:99–105.

    Article  PubMed  CAS  Google Scholar 

  100. Ingemann-Petersen T, Kissmeyer-Nielsen P, Flyvbjerg A, Laurberg S, Christensen H. The effects of insulin-like growth factor I on the healing of experimental colonic anastomoses. Int J Color Dis 1995; in press.

    Google Scholar 

  101. Ziegler TR, Young LS, Ferrari-Baliviera E, Demling RH, Wilmore DW. Use of growth hormone combined with nutritional support in a critical care unit. J Parenteral Enter Nutr 1990;14:574–81.

    Article  CAS  Google Scholar 

  102. Lundeberg S, Belfrage M, Wernerman J, Decken Avd, Thunell S, Vinnars E. Growth hormone improves muscle protein metabolism and whole body nitrogen economy in man during a hyponitrogenous diet. Metabolism 1991; 40:315–22.

    Article  PubMed  CAS  Google Scholar 

  103. Clemmons DR, Underwood LE, Dickerson RO, et al. Use of plasma somatomedin C/insulin-like growth factor I measurements to monitor the response to nutritional repletion in malnourished patients. Am J Clin Nutr 1985; 41:191–98.

    PubMed  CAS  Google Scholar 

  104. Irvin GL, Horsley JS, Caruana JA. The morbidity and mortality of emergency operations for colorectal disease. Ann Surg 1984;199:598–603.

    Article  PubMed  Google Scholar 

  105. Lewis AAM, Khoury GA. Resection for colorectal cancer in the very old: are the risks too high? Br Med J 1988;296:459–62.

    Article  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Christensen, H. (1997). Effect of Growth Hormone Administration on Colonic Healing and Repair. In: Ziegler, T.R., Pierce, G.F., Herndon, D.N. (eds) Growth Factors and Wound Healing. Serono Symposia USA Norwell, Massachusetts. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1876-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1876-0_15

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7321-9

  • Online ISBN: 978-1-4612-1876-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics