789 Split-thickness Skin Graft Meshing: The True Mesh Ratio

Abstract

Abstract Introduction Skin graft meshing is frequently used to allow coverage of extensive wound areas, reduction of donor site size, and prevention of fluid accumulation underneath the skin graft. Meshers allow for various ratios to be used but no studies have confirmed the accuracy of the mesh ratio provided by the manufacturers. The objective of this study was to measure the true mesh ratio achieved using some of the most commonly used skin meshers. Methods A prospective cohort study was performed in 2019. The true expansion ratio was calculated for standardized human split-thickness skin grafts (4x4cm harvested 0.0012in depth using an air dermatome) of the most commonly used meshing ratios (1:1, 1:5:1, 2:1, 3:1, 4:1, and 6:1). Results We had a total of 18 patients resulting in 86 measurements. The study population consisted of 12 males and 6 females; 89% white, 11% non-white; average age of 43 years (SD 21.2). The true mesh ratios of 1:1, 1.5:1, 2:1, 3:1, 4:1, and 6:1 meshers were found to be 1.20 (SD 0.14), 1.55 (SD 0.32), 1.68 (SD 0.32), 2.62 (SD 0.51), 2.87 (SD 0.92), 4.94 (SD 1.35), respectively. The percent errors were 20.2%, 3.3%, -15.8%, -12.5%, -28.3%, -17.7% respectively. Conclusions Mesh ratios of 2:1 meshers and above established by manufacturers are inaccurate. Therefore, overestimation of 2:1 meshers and above is recommended. We recommend an overestimation of 10% or more for meshers 2:1 and above. Applicability of Research to Practice This has significant applicability to practice as it can affect surgical decisions related to estimating the extent of donor area needed to cover skin and soft tissue defects.