Pressure ulcers, also called as bed sores that occurs over a bony prominence due to some localized injury to the dermis or underlying tissue, or both. Anabolic steroids are used as off-label drugs for a while now in the management of pressure ulcers. These have been used as an adjuvant to natural therapy with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are estimated to be supportive in the healing of pressure ulcers. The recent 2017 study by Whittaker and colleagues evaluated the effects of anabolic steroids for treating pressure ulcers.

The authors searched published or unpublished randomized controlled trials in March 2017 . The databases including Cochrane Wounds Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus were searched. The randomized controlled trials (RCTs) included were those, comparing the impacts of anabolic steroids with alternative therapies or different types of anabolic steroids in the treatment of pressure ulcers.

Two authors independently did the study selection, data extraction and risk of bias assessment.

Only a single trial that had involved a total of 212 participants was found. This trial examined the effects of an anabolic steroid (oxandrolone capsules) with a placebo (dummy treatment containing no active medicine) on pressure ulcer healing in people with spinal cord injuries. Most of the included participants were male (98.2%) with a mean age of 58.4 years in the oxandrolone group. They were comparable with the participants in the placebo group (male: 100%; mean age: 57.3 years). The trial was carried over 24 weeks with a further follow-up for eight weeks.

The interim results of the analysis demonstrated that there was unlikely to be a benefit from treatment with oxandrolone. As the data available is also limited from one trial, it is not confirmed whether anabolic steroids can provide beneficial effects on pressure ulcer healing. It is also uncertain that if there will be increasingly severe adverse events with treatment. The procedure may raise the risk of non-serious adverse events.

Overall, the study concluded that no high-quality evidence support the use of anabolic steroids in treating pressure ulcers. Further, there is a need of well-designed, multicenter trials, at low risk of bias to analyse the impact of anabolic steroids in the treatment of pressure ulcers. However, this requires a careful consideration of the current test and its early termination is necessary when planning the future research.