Skin testing. A valuable predictor in thermal injury?

Delayed hypersensitivity skin testing, a prognosticator of sepsis in severely injured patients, has been reported to have varied usefulness following thermal trauma. Skin tests were immediately and sequentially performed with six recall skin-test antigens on 69 patients with burns on greater than 25% of their total body surface area (TBSA). Skin tests were also immediately and sequentially performed with the same recall skin-test antigens on 42 patients with less than 25% of TBSA burned, as controls. In addition, calorie intake was recorded for all patients. Of the 69 patients with greater than 25% of TBSA burned, nine were normal, 13 were relatively anergic, and 47 were anergic. Of the patients in the less than 25% group, 13 were normal, 16 were relatively anergic, and 13 were anergic. In evaluating these data, we concluded that totally anergic patients are no more likely to die of sepsis than are normally responsive patients, nor are they more likely to have sepsis than normal and relatively anergic patients.