Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Electronic address: http://ashalim.usm.my.
Burns. 2019 Sep;45(6):1386-1400. doi: 10.1016/j.burns.2019.04.011. Epub 2019 May 1.
INTRODUCTION: Autologous skin grafting is the mainstay of treatment in burn patients. Extensive full thickness burns remains a challenge to the burns surgeon due to the lack of autologous skin donor sites. The conventional split thickness skin grafting (SSG) and the Meek micrografting (Meek) technique are part of the armamentarium of the burns surgeon to curtail the challenge of paucity of donor sites. With advances in burn care, mortality rates of burn patients have reduced. As a result, with more patients surviving acute burn, there is a paradigm shift of research towards assessment of functional outcomes and quality of life of the burn survivors. As there is lack of research regarding the functional outcome of the Meek technique, this study was designed to examine the long term functional outcome of the Meek technique and SSG in burns. METHOD: A cross-sectional study was conducted in Hospital Universiti Sains Malaysia to assess patients with burns between 10 to 40% total body surface area (TBSA) and with at least one year after injury. The Burn Specific Health Score-brief (BSHS-B) was utilized to compare the functional outcome whilst the Vancouver Scar Scale (VSS) was used for comparison on the scar outcome of the two skin grafting techniques. RESULTS: Forty three patients (Meek,15; SSG,28) were included. The mean current age (years old) of Meek and SSG was 24.7 (range, 7-75) and 25.9 (range, 7-65) respectively. The mean TBSA (%) of the Meek group was 26.7 (range, 13-40) while that of the SSG group was 16.1 (range, 10-32). A simplified domain structure was used for the BSHS-B questionnaire. The work and sexuality subscale were analyzed separately due to missing data. There mean scores of affect and relations was higher in Meek compared to SSG (Meek, 3.86; SSG, 3.75; p > 0.05). Function domain was also better in Meek compared to SSG (Meek, 3.88; SSG, 3.73; p > 0.05). The Meek group displayed superior scar outcome compared to SSG as evidenced by the statistically significant difference in score for the pigmentation, pliability, height and total VSS score. CONCLUSION: The Meek group showed more favorable BSHS-B scores compared to the SSG group. The scar outcome of the Meek technique is significantly superior to SSG. Therefore, the Meek technique is superior in the management of burns because the long term scar and functional outcome of this technique is better compared to conventional SSG.
简介：自体皮移植是烧伤患者治疗的主要方法。由于缺乏自体皮供区，大面积全层烧伤仍然是烧伤外科医生面临的挑战。传统的刃厚皮片移植（SSG）和 Meek 微植皮（Meek）技术是烧伤外科医生的手段之一，可以克服供区不足的挑战。随着烧伤治疗的进步，烧伤患者的死亡率已经降低。因此，随着更多的烧伤患者存活下来，研究的重点已经转向评估烧伤幸存者的功能结果和生活质量。由于缺乏关于 Meek 技术功能结果的研究，因此本研究旨在检查 Meek 技术和 SSG 在烧伤中的长期功能结果。 方法：在马来西亚大学医院进行了一项横断面研究，以评估总体表面积（TBSA）为 10%至 40%且受伤后至少一年的烧伤患者。利用烧伤特异性健康评分-简短版（BSHS-B）来比较功能结果，而温哥华瘢痕量表（VSS）则用于比较两种植皮技术的瘢痕结果。 结果：共纳入 43 名患者（Meek 组 15 名；SSG 组 28 名）。Meek 组和 SSG 组的平均当前年龄（岁）分别为 24.7（范围，7-75）和 25.9（范围，7-65）。Meek 组的平均 TBSA（%）为 26.7（范围，13-40），而 SSG 组为 16.1（范围，10-32）。简化后的域结构用于 BSHS-B 问卷。由于数据缺失，工作和性行为亚量表分别进行了分析。与 SSG 组相比，Meek 组的情感和关系亚量表的平均得分更高（Meek 组 3.86；SSG 组 3.75；p>0.05）。Meek 组的功能域也优于 SSG 组（Meek 组 3.88；SSG 组 3.73；p>0.05）。Meek 组的瘢痕结果明显优于 SSG 组，这一点从色素沉着、柔韧性、高度和总 VSS 评分的统计学显著差异中可以看出。 结论：与 SSG 组相比，Meek 组的 BSHS-B 评分更高。Meek 技术的瘢痕结果明显优于 SSG。因此，与传统的 SSG 相比，Meek 技术在烧伤管理中具有优势，因为该技术的长期瘢痕和功能结果更好。
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