Volume 6, Issue 6, December 2018, Page: 154-158
Meek Micro-grafting Technique in Reduction of Mortality and Hospital Stay in Patients With Extensive Burns in a Resource Constrained Setting
Nangole Ferdinand Wanjala, Division of Plastic Surgery, Department of Surgery, University of Nairobi, Nairobi, Kenya
Ogallo John Paul, Division of Plastic Surgery, Department of Surgery, University of Nairobi, Nairobi, Kenya
Ochieng Raduma Sephania, Department of Surgery, Defence Memorial Hospital, Nairobi, Kenya
Received: Sep. 24, 2018;       Accepted: Nov. 8, 2018;       Published: Dec. 19, 2018
DOI: 10.11648/j.js.20180606.12      View  111      Downloads  19
Abstract
Burns contributes to significant mortality. Among reasons for high mortality is inadequate burn wound management especially in patients with extensive burns and limited donor sites. Majority of the resource constrained countries donot have allografts or tissue cultures that would enable prompt and easy cover ages of such wounds. Skin graft Harvesting techiques such as the Meek micrografts are considered expensive and are thus not available. Patients with extensive burn wounds in many resource constrained countries as a result of this do have poor outcomes with high mortality and prolonged hospital stay. This was a prospective study on patients with extensive burns operated on with theMeek micro-grafting technique in a tertiary teaching Hospital in Kenya. Variables analysed included, total burn surface area, sessions of skin grafts, length of Hospital stay, donor site morbidity and mortality. Twenty five patients with extensive burn wounds were managed with the micro grafting technique over the last three years. The mean total burn surface area for the patients was 46.7 percent with the range of 24 to 72 percent. Five patients died while undergoing treatment giving a mortality rate of 20 percent compared to a mortality rate of 35 percent reported in our centre for patients with the similar burn surface area operated on with the mesh technique. The mean length of Hospital stay was 73.92 days compared to a Hospital stay length of 97.4 days previously reported prior to this technique. The mean donor size surface area was 15.8%. The average length of time the donorsite wounds healed was 16.7 days. Three patients had wound sepsis at the donor site that healed after dressing with silver based dressing materials. Meek micro grafting technique allows for extensive coverage of burn wounds with a relatively small donorsite. The technique is associated with reduced donor site morbidity, mortality and length of Hospital stay. This technique should be encouraged in many burn centers in developing countries where there are patients with extensive burn wounds.
Keywords
Meek Micro-grafting, Length of Hospital Stay, Mortality
To cite this article
Nangole Ferdinand Wanjala, Ogallo John Paul, Ochieng Raduma Sephania, Meek Micro-grafting Technique in Reduction of Mortality and Hospital Stay in Patients With Extensive Burns in a Resource Constrained Setting, Journal of Surgery. Vol. 6, No. 6, 2018, pp. 154-158. doi: 10.11648/j.js.20180606.12
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Ndung’u K. J. Pattern of presentation, management and early outcome of burns as seen at Kenyatta National Hospital; Dissertation presented in Dept of Surgery University of Nairobi 2007.
[2]
Mbaga F. W., Mwafongo V. G. A Profile of Burn injury in Dar es Salaam, Tanzania. Tanzania Medical Journal 1998; 3 (2): 8-12.
[3]
Mureithi E K. Correlationof initial serum lactic acid and base deficit with early mortality in patients admitted with major thermal Burns at the burns at the burns unit in Kenyatta National Hospital. Disseration Presented In Dept OF Surgery Universty of Nairobi, 2017.
[4]
Peeters R, Hubens A. The mesh skin graft—true expansion rate. Burns 1988; 14(3): 239–240. https://doi.org/10.1016/0305-4179(88)90047-2Crossref, Google Scholar.
[5]
Kreis RW, Mackie DPHemansRP, Vloemans AR. Expansion techniques for skin grafts: comparison between mesh and Meek Island (sandwich-) grafts. Burns 1994; 20(I Suppl 1): S39–S42. https://doi.org/10.1016/0305-4179(94)90088-4Crossref, Medline, Google Scholar.
[6]
Lumenta B, Kamolz L, Keck M, and FreyM. Comparison of meshed versus MEEK micrografted skin expansion rate: claimed, achieved, and polled results. Plast Reconstruct Surg 2011; 128; (1): 40–41. https://doi.org/10.1097/PRS.0b013e318217463aCrossref, Google Scholar.
[7]
M. Saaiq, S. Zaib, S. Ahmad Early excision and grafting versus delayed excision and grafting of deep thermal burns up to 40% total body surface area: a comparison of outcomeAnn Burns Fire Disasters. 2012 Sep 30; 25(3): 143–147.
[8]
Mehdi Ayaz, Hamid Bahadoran, Peyman ArastehEarly Excision and Grafting versus Delayed Skin Grafting in Burns Covering Less than 15% of Total Body Surface Area; A Non- Randomized Clinical Trial. Bull Emerg Trauma. 2014 Oct; 2(4): 141–145.
[9]
Fang T, Lineaweaver WC, Sailes FC, Kisner C, ZhanG FClinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries Ann Plast Surg. 2014 Nov; 73(5): 509-15. doi: 10.1097/SAP.0b013e3182840883.
[10]
Quintero EC, Machado JFE, Robles RAD. Meek micrografting history, indications, technique, physiology and experience: a review article. J Wound Care. 2018 Feb 1; 27 (Sup2): S12-S18.doi: 10.12968/jowc.2018.27.Sup2.S12.May 2012Volume 38, Issue 3, Pages 307–318.
[11]
Rode H, Martinez R, Potgieter D et al Experience and outcomes of micrografting for major pediatric burns. J Burns. 2017 Aug; 43(5): 1103-1110. doi: 10.1016/j.burns.2017.02.008. Epub 2017 Mar 18.
Browse journals by subject