The clinical course of multiply injured patients is dependent upon a broad variety of different factors. The complex immunological consequences of trauma can cause further complications, e.g. local infections or even sepsis. Moreover, after successful initial trauma care it is of great importance to find the optimal time point for a secondary surgery. The surgical trauma must not be the “second hit” inducing an immunological cascade which finally often leads to multiple organ failure.
Besides clinical symptoms, laboratory parameters are recognized for diagnosis of inflammatory reactions during the initial posttraumatic period. The most common biomarkers, e.g. leukocyte count, C-reactive protein and interleukin-6, are useful in diagnosis of septic complications. However, sequential measurement of procalcitonin seems to have more advantages in differentiating SIRS from sepsis compared with the “old” biomarkers. In the future, however, not one biomarker alone should be responsible for the decision about which therapy is applied. Moreover, laboratory parameters can only help with the decision for or against a certain therapy and with finding the optimal time point for surgical intervention.