The MEEK
The 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.
UNIQUE FEATURES
The MEEK micrografting devices are made to easily apply the MEEK technique. The MEEK machine allows the user to easily and controllably cut skin grafts of 42 mm × 42 mm (1.65” × 1.65”) into smaller pieces of skin of 3 mm × 3 mm in size. These skin islands are then transferred to specially folded gauzes. Upon expansion of the gauzes, the distance between the individual islands is increased. The way the gauzes have been folded determines the expansion ratio. Originally postulated to treat burns by dr. Meek in 1958, the then called MEEK-Wall technique required tremendous skill for it to be applied successfully. Despite positive results, the technique was shelved when mesh grafting was introduced in 1964. Decades later new technology bred new possibilities and the MEEK-Wall technique was modified by Humeca in cooperation with surgeons of the burn center of the Red Cross Hospital at Beverwijk, The Netherlands
After years of research and development, a newly
designed machine was introduced onto the market in 1993. The MEEK machine and prefolded gauzes ironed out many steps of the original procedure. Since its release, the modified MEEK technique has been sold to burn centers worldwide and is used every day. Most techniques are limited in the size of burn wounds they can treat. However, the MEEK technique is suitable for small and large TBSA burns. Gauzes with expansion ratios of 1:2, 1:3, 1:4, 1:6 and 1:9 are available. The expansion ratio of the gauzes is mathematically supported, which makes the need for donor site availability smaller when compared to the donor site needed for other skin grafting techniques. Additionally, clinical outcome and success rate of MEEK micrografting have shown to be increased when compared to other skin grafting methods. This is partly related to faster epithelialization and wound closure.
Features
• Superior results compared to mesh grafting.
• Suitable for complex cases with unfavorable wound conditions.
• Uniform epithelization due to homogenous distribution of skin islands, of which the dermal sides are in full contact with the wound bed.
• Faster full epithelialization compared to mesh grafting, which is caused by a larger total margin and a shorter distance between skin margins.
• The epithelization time for a 1:6 expansion using MEEK is 3 – 4 weeks.
• The risk of infection is lower compared to mesh grafting due to, among others faster epithelialization.
• Suitable for small and large percentages TBSA.
• True expansion ratio resulting in a required smaller donor site size or the ability to treat a larger percentage TBSA using the same donor site size compared to mesh grafting.
• Suitable for a combined treatment with primary or cultured skin cell therapies.