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A Potential Cause of Burn Wound Sepsis

Edwin A. Deitch, MD; Marek Dobke; Charles R. Baxter, MD

Arch Surg. 1985;120(1):78-84.

Abstract
• Destruction of the skin barrier by thermal injury removes the major local defense barrier to bacteria. To determine whether a local defect in immunity also existed, the opsonic activity of blister fluid against Staphylococcus aureus and Pseudomonas aeruginosa as well as neutrophil chemotaxis were measured. The results of these studies indicated that blister fluid could not opsonize Pseudomonas. A series of repletion experiments indicated that the opsonic defect for Pseudomonas was not due to the presence of inhibitors but was due to the lack of normal serum factor(s). Although both the level of immunoglobulins and complement components in the blister fluid was depressed, the cause of the opsoninopathy appeared to be due to local consumption of complement in the burn wounds. In addition to the opsoninopathy, both neutrophil chemotaxis and random migration were also depressed. In conclusion, a burn injury appears to cause severe impairment of both cellular and humoral local immunity, which could predispose these patients to burn wound sepsis.

(Arch Surg 1985;120:78-84)

Author Affiliations
From the Louisiana State University (LSU) Medical Center, Shreveport (Dr Deitch); and the Southwestern Medical School, Dallas (Drs Dobke and Baxter).

Footnotes
Accepted for publication Aug 21, 1984.

Read before the Fourth Annual Meeting of the Surgical Infection Society, Montreal, April 30, 1984.

Reprint requests to PO Box 33932, LSU Medical Center, Shreveport, LA 71130 (Dr Deitch).

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