Delayed cutaneous hypersensitivity after multiple injury and severe burn.

LetHality and overall prognosis after multiple injury and severe burn are determined to a major degree by the incidence and severity of infectious complications. Immunological reactions are influenced by the extent of trauma. Multitest Mérieux is an appropriate and an easily applicable means to delayed hypersensitivity testing (DHT). This study investigates to what extent Multitest Mérieux can help to predict the prognosis of multiply injured and severely burnt patients and whether new therapeutic measures can be recommended. This study encloses 52 patients during 1985: 16 severe burns, 20 multiple injuries with craniocerebral trauma and 16 without. Beginning with the day of injury standard laboratory and cardiopulmonary parameters were recorded every 48 hours. Delayed hypersensitivity testing was performed using Multitest Mérieux. The extent of trauma was determined by help of the ISS. All quantitative laboratory and cardiopulmonary parameters showed no significant changes in correlation to the clinical course during the period under investigation. However, a significant correlation between Multitest reaction at days six and eight and its overall results and the rate of infectious complications was found. Moreover, the extent of trauma measured by ISS shows a positive correlation with the rate of anergic reactions in Multitest. Thus Multitest Mérieux is an easily applicable and reliable means to the assessment of the prognosis after multiple injury and severe burn. Therapeutical recommendations beyond today's intensive care concepts cannot be given.