MEEK MICROGRAFTING TECHNIQUE AND ITS USE IN THE TREATMENT OF SEVERE BURN INJURIES AT THE UNIVERSITY HOSPITAL OSTRAVA BURN CENTER.

BACKGROUND

Early necrectomy and skin autotransplantation are prerequisites for successful treatment of extensive burns. Insufficient autograft donor site availability is a limiting factor. The Meek micrografting technique, published by C. P. Meek in 1958, appears to be a potential solution. Skin grafts are cut into micrografts and expanded at a ratio of 1:3, 1:4, 1:6 or 1:9. Thus, even in cases with limited donor site availability, it is possible to cover large areas after necrectomy.

MATERIAL AND METHODS

Meek micrografting was first used at the University Hospital Ostrava Burns Centre in 2013. To date, 14 operations have been performed in 4 patients with extensive burn trauma. Engraftment, healing rate, and subsequent scarring (with a particular focus on scar contracture formation) were observed postoperatively.

RESULTS

The average micrograft success rate was 86.5%. The best success rates were observed in areas with deferred transplantation after necrectomy. Hypertrophic scarring occurred in both Meek and meshed transplant areas. No scar contractures requiring surgical management developed in micrografted areas. Surgical scar contracture release was required in 1 patient who underwent meshed graft transplantation.

DISCUSSION

The Meek technique demonstrated significant advantages. Micrografts can be prepared with very small skin grafts, which is impossible with the mesh technique. Meshed grafts with expansion ratios of 1:3 or higher require allograft or xenograft coverage. In our experience, overlays were not necessary for micrografts with a 1:6 expansion ratio. Given that no serious scar contractures developed in micrografted areas, we speculate that micrografts may pose a lower risk for their development when compared to meshed grafts. The disadvantage of the Meek technique is greater economic demands.

CONCLUSION

Meek micrografting is effective in the surgical management of deep burns in extensive thermal injuries with limited donor site availability...