title: The modified Meek technique as a novel method for skin grafting in horses: evaluation of acceptance, wound contraction and closure in chronic wounds.
abstract: BACKGROUND
  The acceptance of skin grafts in horses is unpredictable and the final cosmetic result can be disappointing. Besides movement and infection, graft failure is often caused by chronic inflammation, inherently present during second intention healing of limb wounds in horses. In human burns affected by infection and inflammation, the acceptance of the island skin grafts of the modified Meek technique appeared to be better than meshed sheet skin grafts.
  
  
  OBJECTIVE
  The percentage take of Meek micrografts is higher than of other techniques; and rates of both wound contraction and epithelialisation are increased.
  
  
  METHODS
  Large traumatic limb wounds of 13 horses healing by second intention were grafted using the modified Meek technique. Photographs of the wounds were taken at set intervals. Wound areas, and areas of acceptance and rejection were determined using a digital image post processor (Scion Image). The percentages of take, wound contraction and epithelialisation were calculated.
  
  
  RESULTS
  The initial mean wound area was 7500 mm2. Graft acceptance was mean +/- s.d. 93.7 +/- 5.9%. Wound closure was due to contraction (55.2 +/- 11.1%) and epithelialisation (44.8 +/- 11.1%) and resulted in a 96.7 +/- 3.6% reduction of the initial wound area 29.1 +/- 6 days after grafting. All wounds showed functional and cosmetic healing.
  
  
  CONCLUSIONS
  The method for skin grafting in horses achieved higher percentages of take than reported previously and consistent cosmetic and functional results. The grafts increased not only the rate of epithelialisation but also had a strong positive effect on wound contraction, resulting in rapid closure and smaller scars.
  
  
  CONCLUSIONS
  The modified Meek technique proved to be a novel technique for skin grafting equine wounds in clinical practice, which can be performed easily. The molecular background of the increase of wound contraction by the grafts may provide a clue in the search for medicinal stimulation of wound contraction during second intention healing.
authors.affiliation: Woumarec, Wageningen, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Wilmink
authors.forename: R
authors.initials: R
authors.lastname: van den Boom
authors.forename: P R
authors.initials: PR
authors.lastname: van Weeren
authors.forename: A
authors.initials: A
authors.lastname: Barneveld
mesh_terms: D000818:Animals; D004848:Epithelium / Q000637:transplantation*; D005260:Female; D006085:Graft Survival; D006736:Horses / Q000293:injuries / Q000601:surgery*; D008297:Male; D016038:Skin Transplantation / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D013526:Surgical Mesh; D013997:Time Factors; D046509:Tissue Culture Techniques / Q000662:veterinary; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000601:surgery / Q000662:veterinary*