EXPANSION TECHNIQUES FOR SKIN-GRAFTS - COMPARISON BETWEEN MESH AND MEEK ISLAND (SANDWICH) GRAFTS

In skin grafting operations for Patients with extensive burn injuries, mesh techniques are often employed to enlarge the effective surface a rea covered by autografts. However, substantial strips of autograft ar e required and the distribution of autograft elements on the wound sur face is relatively uneconomical. An alternative technique for expandin g autografts, first described by Meek in 1958, makes use of a special dermatome and prefolded gauzes to obtain a regular expansion of autogr aft squares from small pieces of split skin grafts. In a simple in vit ro experiment using allograft skin, the expansion ratio obtained with the Meek micrograft technique was measured at almost 1:9. In contrast, the expansion ratio obtained with allograft meshed '1:6' with a Zimme r Dermatome II was measured at 1:4. The maximum distance between the g raft elements obtained with the Meek technique was 9 mm, compared to a maximal distance between the strands of the mesh graft of 12 mm. The Meek technique is a useful alternative to mesh grafts when donor sites are limited. Clinical experience suggests that Meek grafts are also p articularly suitable for grafting on granulating wounds under poor con ditions.