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改良Meek技术与标准网状植皮法治疗三度烧伤患者的比较

Comparison of Modified Meek Technique with Standard Mesh Method in Patients with Third Degree Burns.

作者信息

Dahmardehei Mostafa, Vaghardoost Reza, Saboury Mahdy, Zarei Hamze, Saboury Shahriar, Molaei Mehdi, Seyyedi Jalal, Maleknejad Abdulbaset

机构信息

Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Department of Plastic and Reconstructive Surgery, St. Fatima Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

World J Plast Surg. 2020 Sep;9(3):267-273. doi: 10.29252/wjps.9.3.267.

Abstract

BACKGROUND

Covering burn wounds, especially high surface area burns has been always a challenge for surgeons. The Meek technique has been introduced to increase the covering area. There is paucity of clinical trials comparing the Meek technique and mesh in the same individuals to assess it efficacy.

METHODS

In a case-control study, 20 patients with grade III burns who underwent the Meek technique and mesh in different areas/limbs were enrolled. Expansion rate, re-epithelization, operation time, wound infection, graft failure, etc. were compared between the two groups.

RESULTS

Among patients, 18 were males and 2 were females. The mean of total body surface area (TBSA) was 36.9±16.6%. Mean time of re-epithelialization in the Meek group was 2.8±2.5 months and in the mesh group was 5.0±2.1 months (=0.01). Operation time was shorter in modified Meek technique (=0.04). Expansion ratio was higher in modified Meek technique (=0.04). Local wound infection rates were slightly different without a statistically significant difference.

CONCLUSION

Meek technique provided higher surface area coverage in comparison to mesh; in addition to faster re-epithelization. Therefore, it is recommended to consider the Meek technique as a routine procedure, especially those with high surface area burns.

摘要

背景

覆盖烧伤创面,尤其是大面积烧伤创面一直是外科医生面临的挑战。米克技术已被引入以增加覆盖面积。缺乏在同一患者中比较米克技术和网状植皮的临床试验来评估其疗效。

方法

在一项病例对照研究中,纳入了20例在不同部位/肢体接受米克技术和网状植皮的Ⅲ度烧伤患者。比较两组的扩张率、再上皮化、手术时间、伤口感染、植皮失败等情况。

结果

患者中,男性18例,女性2例。总体表面积(TBSA)的平均值为36.9±16.6%。米克组的平均再上皮化时间为2.8±2.5个月,网状植皮组为5.0±2.1个月(=0.01)。改良米克技术的手术时间更短(=0.04)。改良米克技术的扩张率更高(=0.04)。局部伤口感染率略有差异,但无统计学意义。

结论

与网状植皮相比,米克技术提供了更高的表面积覆盖率;此外再上皮化更快。因此,建议将米克技术视为常规手术,尤其是对于大面积烧伤患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc40/7734932/267eb72c1e14/wjps-9-267-g001.jpg

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