The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique

Danielle Rijpma; Karel Claes; Henk Hoeksema; Ignace de Decker; Jozef Verbelen; Stan Monstrey; Anouk Pijpe; Paul van Zuijlen; Annebeth Meij-de Vries

doi:10.1016/j.burns.2022.05.011

The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique

Burns. 2022 Sep;48(6):1287-1300. doi: 10.1016/j.burns.2022.05.011. Epub 2022 May 13.

Authors

Danielle Rijpma¹, Karel Claes², Henk Hoeksema², Ignace de Decker², Jozef Verbelen³, Stan Monstrey², Anouk Pijpe¹, Paul van Zuijlen⁴, Annebeth Meij-de Vries⁵

Affiliations

¹ Burn Centre, Red Cross Hospital, Vondellaan 13, Beverwijk 1942 LE, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Science's Amsterdam UMC (Location VUmc), De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands; Association of Dutch Burn Centres, Burn Centre, Rode Kruis Ziekenhuis, Beverwijk, the Netherlands.
² Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, Ghent 9000, Belgium; Ghent Burn Center, Ghent University Hospital, C. Heymanslaan 10, Ghent 9000, Belgium.
³ Ghent Burn Center, Ghent University Hospital, C. Heymanslaan 10, Ghent 9000, Belgium.
⁴ Burn Centre, Red Cross Hospital, Vondellaan 13, Beverwijk 1942 LE, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Science's Amsterdam UMC (Location VUmc), De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Vondellaan 13, Beverwijk 1942 LE, the Netherlands; Department of Pediatric Surgery, Amsterdam UMC, AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands.
⁵ Burn Centre, Red Cross Hospital, Vondellaan 13, Beverwijk 1942 LE, the Netherlands; Department of Pediatric Surgery, Amsterdam UMC, AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Department Surgery, Red Cross Hospital, Vondellaan 13, Beverwijk 1942 LE, the Netherlands. Electronic address: adevries@rkz.nl.

PMID: 35718572
DOI: 10.1016/j.burns.2022.05.011

Abstract

Introduction: Autologous split thickness skin grafting is the standard-of-care for the majority of deep dermal and full thickness burns: Meshed grafting is most commonly used. Patients with extensive burn injuries have limited donor site availability. Meek micrografting is a well-known technique to enable larger expansions. A review was conducted on the outcomes of the Meek micrograft technique.

Method: A database search in PubMed, Web of Science, Google Scholar and the Cochrane Library was conducted from the first Meek micrografting report in 1958 until 2021, including terms 'burns', 'micrografting' and/or 'Meek'. Original papers reporting outcomes of Meek micrografting were included.

Results: 1529 papers were identified and eventually 15 articles were included, the majority classified as poor quality according to Chambers criteria. 310 patients with 56% mean TBSA were described. Weighted averages were calculated for 'graft take' 82 ± 7%, 'time to wound closure' 53 ± 20 days and 'length of hospital stay' 61 ± 31 days. Scar quality was minimally described and often poorly assessed. Limited data were available on outcomes 'donor site size', 'number of operations', 'cost effectiveness' and 'bacterial load/wound infection rate'.

Conclusion: Overall poor study quality and the specific lack of data on scar quality, made it impossible to draw conclusions on the outcomes of Meek micrografting. A randomized controlled trial is required to further investigate the performance of the Meek micrograft technique.

Keywords: Burns; Graft take; Meek micrograft technique; Mesh graft technique; Scar quality; Time to wound closure.

Publication types

Review

MeSH terms

Burns* / surgery
Cicatrix / surgery
Humans
Skin
Skin Transplantation* / methods
Transplantation, Autologous / methods