The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique. Issue 6 (September 2022)

• Record Type: Journal Article
• Authors: Rijpma, Danielle; Claes, Karel; Hoeksema, Henk; de Decker, Ignace; Verbelen, Jozef; Monstrey, Stan; Pijpe, Anouk; van Zuijlen, Paul; Meij-de Vries, Annebeth
• Is Part Of: Burns. Volume 48:Issue 6(2022)
• Page Start: 1287
• Page End: 1300
• Publication Date: 2022-09
• Subjects: BSHS-B Burn Specific Health Score-Brief -- DD Deep Dermal -- FT Full Thickness -- LOS Length of hospital Stay -- NOS Newcastle Ottawa Scale -- STSG Split Thickness Skin Grafts -- SSG Split Skin Grafts -- TBSA Total Body Surface Area -- CEA Cultured Epidermal Autografts -- POSAS Patient and Observer Scar Assessment Scale -- VSS Vancouver Scar Scale; Burns -- Meek micrograft technique -- Mesh graft technique -- Graft take -- Time to wound closure -- Scar quality; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2022.05.011
• Languages: English
• ISSNs: 0305-4179

Abstract

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. Highlights: The Meek micrograft technique is almost exclusively used for burns> 30% total body surface area. Fifteen studies on the outcomes of Meek micrografting were found. Studies concerning outcomes of Meek micrografting are of mainly poor quality. A randomized controlled trial of Meek micrografting versus mesh grafting on clinical and patient-reported outcomes is needed.