Failure of local immunity. A potential cause of burn wound sepsis
E. A. Deitch, M. Dobke and C. R. Baxter
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.
