Delayed hypersensitivity skin testing in elective colorectal surgery and relationship to postoperative sepsis

Delayed hypersensitivity skin testing to five common recall antigens (Varidase, Candida, PPD, Trichophyton, and Mumps) was performed on 50 patients undergoing elective colorectal surgery. Eighteen patients showed an altered response to skin testing (11 relative anergy, seven total anergy) and this group of patients had a significant increase in both total septic complications (p less than 0.001) and major septic complications (p less than 0.05) following operation. Anergy in these patients did not correlate with nutritional status, but it did relate to stage of the tumor in patients with cancer. The low specificity of abnormal delayed hypersensitivity skin testing and its failure to be related to malnutrition limits the practical application of this technique in patients undergoing elective colorectal surgery.