Meek Micro-grafting Technique in Reduction of Mortality and Hospital Stay in Patients With Extensive Burns in a Resource Constrained Setting

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.