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Updated: Oct 1, 2025
A Murine Model of a Burn Wound Reconstructed with an Allogeneic Skin Graft
Published on: August 8, 2020
Comparative study between skin micrografting (Meek technique) and meshed skin grafts in paediatric burns
Marwan Ahmed Noureldin1, Tarek Ahmed Said1, Khaled Makeen1
1Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt.
Insights
The Meek technique significantly improves skin graft take and aesthetic outcomes in pediatric burn patients compared to traditional meshing. While it requires more operative time, it offers better results for wound healing and scar appearance.
Area of Science:
- Regenerative Medicine
- Plastic Surgery
- Pediatric Burn Care
Background:
- Burn injuries are a leading cause of death in children.
- Managing pediatric burns is challenging due to limited donor sites and cosmetic concerns.
- Skin graft expansion techniques are crucial for optimal wound coverage.
Purpose of the Study:
- To compare the efficacy of the Meek technique versus the traditional mesher for skin graft expansion in pediatric burn patients.
- To evaluate graft take, epithelialization time, operative time, and aesthetic outcomes.
Main Methods:
- A prospective comparative randomized study involving 40 pediatric burn patients.
- Patients were divided into two groups: Meek technique and meshed group.
- Outcomes were assessed at three months postoperatively using the Patient and Observer Scar Assessment Scale (POSAS).
Main Results:
- The Meek group showed a significantly higher graft take percentage (84.25%) compared to the meshed group (71.5%).
- The Meek technique resulted in better subjective and observer scar assessment scores.
- Operative time was longer for the Meek technique, but infection rates and epithelialization time were comparable or improved.
Conclusions:
- The Meek technique offers superior graft take and aesthetic results for pediatric burn wound management.
- Despite a longer operative time and learning curve, the Meek technique is a valuable alternative for skin graft expansion.
- Further research may explore cost-effectiveness and optimization of the Meek technique.
Background:
Globally, burn injuries are the 3rd principal cause of death due to injury among children aged 1-9 years. Yet, the management of paediatric burns is always challenging; due to limited donor sites and the cosmetic appearance that will affect the child later in life, either at the donor or the recipient site. Skin grafts may need to be expanded to minimise donor skin size or in patients with limited donor sites. Multiple techniques were described for graft expansion, mainly the mesher and the Meek technique.
Patients And Methods:
A prospective comparative randomised study was done from January 2019 to June 2020 on 40 paediatric burn patients with deep dermal and full-thickness burns. Patients were divided into two groups, Meek and meshed groups. The skin graft take, epithelialization time, total time of the surgery and the aesthetic outcomes (using the POSAS - Patient and observer scar assessment scale) in each group were evaluated at three months postoperatively.
Results:
The percentage of take in the Meek group (84.25%) was significantly better than with the meshed group (71.5%) (P = 0.006). Epithelialization time was better for the Meek group (27.11 days) compared to the meshed group (33.5 days) (P = 0.176). In addition, infection rates were lower in the Meek group (25%) than the meshed group (40%) (P = 0.311). Subjectively POSAS scar assessment scale exhibited better results for the Meek group with a mean score of 3.17 & for the meshed group was 4.2 (P = 0.048). The observer's overall score was as well better for the Meek group with a mean overall opinion score of 2.89 & for the meshed group was 4.1 (P = 0.003). The operative time was longer with the Meek technique than the traditional mesher (P < 0.001).
Conclusion:
The Meek technique for expanding the skin grafts is useful in covering burn wounds with greater expansion rate, more accessible application, better graft take & a better scar appearance than the traditional mesher. Still, the Meek technique has a considerable learning curve, longer procedure time & is more expensive.
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