ABSTRACT
BACKGROUND: Early necrectomy and skin autotransplantation are prerequisites for successful treatment of extensive burns. Insufficient autograft donor site availability is a limiting factor. The Meek micrografting technique, published by C. P. Meek in 1958, appears to be a potential solution. Skin grafts are cut into micrografts and expanded at a ratio of 1:3, 1:4, 1:6 or 1:9. Thus, even in cases with limited donor site availability, it is possible to cover large areas after necrectomy. MATERIAL AND METHODS: Meek micrografting was first used at the University Hospital Ostrava Burns Centre in 2013. To date, 14 operations have been performed in 4 patients with extensive burn trauma. Engraftment, healing rate, and subsequent scarring (with a particular focus on scar contracture formation) were observed postoperatively. RESULTS: The average micrograft success rate was 86.5%. The best success rates were observed in areas with deferred transplantation after necrectomy. Hypertrophic scarring occurred in both Meek and meshed transplant areas. No scar contractures requiring surgical management developed in micrografted areas. Surgical scar contracture release was required in 1 patient who underwent meshed graft transplantation. DISCUSSION: The Meek technique demonstrated significant advantages. Micrografts can be prepared with very small skin grafts, which is impossible with the mesh technique. Meshed grafts with expansion ratios of 1:3 or higher require allograft or xenograft coverage. In our experience, overlays were not necessary for micrografts with a 1:6 expansion ratio. Given that no serious scar contractures developed in micrografted areas, we speculate that micrografts may pose a lower risk for their development when compared to meshed grafts. The disadvantage of the Meek technique is greater economic demands. CONCLUSION: Meek micrografting is effective in the surgical management of deep burns in extensive thermal injuries with limited donor site availability...
Subject(s)
Burn Units , Burns , Skin Transplantation , Burns/surgery , Hospitals, University , Humans , Transplantation, AutologousABSTRACT
Lyells syndrome, also known as toxic epidermal necrolysis (TEN), is a rare skin disease characterized by a high mortality rate, systemic toxicity and extensive epidermal necrolysis with mucosal erosions. TEN is caused by an allergic autoimmune response, most commonly occurring as a result of an allergic reaction to medication. Our case report describes a nine-year-old boy suffering from Lyells syndrome, with 95% of the body surface area affected.
