MEEK Micrografting

Every doctor will admit, burn wound treatment involves multiple challenges. There is a great risk of infections and poor epithelialization and the lack of auto graft donor sites is a limiting factor in achieving wound closure in cases of extensive skin defects.

Current mesh graft techniques cannot meet the requirements which are needed to treat a patient in the best way. Therefore, in cooperation with surgeons of the burn center of the Red Cross Hospital Beverwijk, The Netherlands, Humeca re-designed and modernized the MEEK technique. Originally, the MEEK technique was described by Mr. Cicero Parker Meek from the University of South Carolina Aiken (USCA), USA in 1958. However, this original technique required too much skill and it became eclipsed by the introduction of mesh skin grafts by Tanner et al. in 1964 and was eventually discontinued. In the early 1990’s two surgeons from the Red Cross Hospital, Beverwijk, in The Netherlands approached Humeca and asked for help in re-introducing a modified meek technique.

After much engineering and re-design the modified meek technique was finalized and released in 1993. Since then, the modernized MEEK technique has been sold to burn centers worldwide and there have been numerous publications written supporting its use.

Our unique MEEK technique is reported to be superior to other grafting methods. Imperfections of the original method were overcome and the prefolded gauzes are now manufactured with expansion ratios 1:3, 1:4, 1:6 and 1:9. The clinical results are excellent, even in problematic zones and in case of inferior wound beds. The method appears to be a simple technique to achieve a regular distribution of postage stamp grafts, correctly orientated to the surface of the wound.

In the next video you will explore the uniqueness of our revolutionary MEEK technique.

Flexible production line medical products

Humeca is participating in a project with partners for flexible production of medical products. This project is partially funded by an EFRO subsidy.

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Unique MEEK features

MEEK video

  • Very small donor sites required
  • Large expansion ratios, up to 1:9, possible
  • Any small skin fragments can be used so no precious donor skin is wasted
  • Fast and uniform epithelialization
  • Excellent graft take due to correctly orientated graft islands
  • Failure of a few islands does not affect overall graft take
  • Cosmetic results comparable with mesh grafts of a lower expansion
  • Grafts very easy to manipulate
  • Less infections to faster healing process.

MEEK Micrograft is more than a product. It is a unique technique where research shows that burn wounds are closing twice as fast as with the Mesher, there is a significant decrease of infections.

Currently MEEK is mainly used for patients that suffer  more than 30% TBSA burns. However MEEK is also very suitable for patients with 5% –  20% TBSA burns. In most cases, 40 – 50% less donor sites have to be used and these same donor sites could be used again within two weeks.

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Meek, the solution for burn surgeons treating severe burn wounds

All burn surgeons worldwide face the same problems in treatment of severe burn wounds such as limited donor sites and difficulty in handling widely meshed skin grafts, especially when expansion ratios of 1:3 and higher are required.
The expansion ratios of these mesh grafts are not realistic as 25% – 40% is lost during meshing and handling.
We are proud to be the exclusive supplier of the modified MEEK technique, the solution to all of these problems.

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Cases

Case by Dr. A.W.F.P. Vloemans, Surgeon at the Burns Centre of Red Cross Hospital Beverwijk, The Netherlands.

The MEEK Micrograft technique offers a more effective expansion rate of a split skin graft than the meshgraft technique. From the first experiences with the MEEK technique in our Burns Centre, it showed that the take of the graft was very good, despite a qualitatively inferior wound bed. Here we present a case of a patient with an extensive skin and soft tissue defect, that was treated in our Burns Centre.

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Case by Prof. Ognian Hadjiiski, MD, Pirogov Emergency Medical Institute, Sofia, Bulgaria.

The patient, a 16 year old male who sustained a 65% TBSA flame burn in the back, chest, arm and legs, was brought into our center 14 hours after the accident. He was in thermal shock and had inhaled smoke. On day 3, 5 and 7 we performed early surgical excision of the necrotic tissue in the legs, chest and belly in 32% TBSA, leaving 14% disseminated necrotic tissues. The wound surfaces were covered with micrografts in five surgical steps every third to fifth day. The total donor site area was 14%. The donor sites were large because of the need to change some of the marks in subsequent surgical stages. During treatment the patient developed generalized bacterial infection, which was appropriately treated. On day 79 he was discharged in good health.

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A publication in Burns by R. Peeters and A. Hubens

In their publication in Burns, 14 (3), 239-240 (1988), R. Peeters and A. Hubens of the Antwerp Stuivenberg Hospital, Belgium, prove that the actual expansion ratio of a meshgraft is much less than the given one. They compared the expanded graft surface area to the surface of the graft taken from the patient. Based on their findings we calculated how much graft is needed to cover a 100 cm2 burn wound in case of meshing and in case of MEEK. See the results. The vertical axis presents the required graft surface and the horizontal axis the true expansion ratio.

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