Publication:

The Meek technique versus partial-thickness skin graft in major burns patients: experience in the National Center of Research and Care of Burns Patients in Mexico City

Background The Meek technique, originated in the 1950s by Cicero Parker Meek is one of the most important techniques used in the treatment of major burns, particularly due to the scarcity of donor sites for single skin grafts. Despite advances in the care of burn patients, there is no universally effective treatment, particularly for major burn patients. Meek grafts exhibit reduced susceptibility to loss due to infection, favorable outcomes are achieved, with reported graft survival rates ranging from 86-95%, along with satisfactory functional and aesthetic outcomes. The modified Meek technique was associated with shorter operation times (p=0.04) and a greater expansion ratio (p=0.04). The Meek technique is considered a cornerstone in the treatment of extensive burns, particularly when donor sites are limited for conventional split-thickness skin grafts. Despite advances in burn care, there is still no universally effective treatment for patients with major burns.

Methods A clinical, observational, cross-sectional study conducted from March 2022 to February 2024, comparing hospital length of stay (LOS), intensive care unit LOS, and outcomes in patients with major burn injuries. We compared these data between the Meek technique (n=11) and split-thickness skin grafting (STSG) (n=27).

Results Among the patients, in the Meek group (n=11), 6 were male, while in the STSG group (n=27), 18 were male. The mean total body surface area (TBSA) for the Meek group was 63.9±17.9%, and for the STSG group, it was 63.6±19% (p=0.97). The mean LOS at the hospital for the Meek group was 41.1±18 days, while for the STSG group, it was 27.2±22 days (p=0.10). The LOS in the intensive care unit was 32.1±13.1 days for the Meek group and 19.4±11.2 days for the STSG group (p=0.04). A higher frequency of deaths was observed with the STSG technique compared to the Meek technique (59.3% versus 45.5%; p=0.03).

Conclusions Preliminary results with the Meek technique are encouraging, showing a lower death rate in patients with severe burns. However, the prolonged LOS is a risk factor to consider in this group of patients.