title: Skin graft meshing, over-meshing and cross-meshing.
abstract: BACKGROUND
  Split skin grafts (SSGs) are often meshed to increase their size and allow exudate to escape. We investigated the expansion obtained with meshing, and the possibility of re-meshing skin that has already been meshed ("overmeshing"). Both useful and inadvisable permutations are illustrated.
  
  
  METHODS
  Thin porcine SSGs were sideways meshed, or meshed with ratios of 1.5:1 and 3:1. Subsequently samples were over-meshed in a variety of ratios and directions. All grafts were maximally expanded and their areas calculated.
  
  
  RESULTS
  Meshed skin did not expand as much as suggested by the ratios displayed on dermacarriers. A 1:1.5 dermacarrier produced an area expansion of 1.36×, and a 1:3 meshing apparatus produced only a 1.80×area expansion. Several combinations of twice-meshed SSGs maintained integrity as long as over-meshing was done in the axis of initial meshing. Up to 2.3×expansion was obtained, by following a 1:1.5 mesh with a 1:3 mesh. We term this procedure as "overmeshing". Re-meshing in a direction orthogonal to initial meshing (cross meshing) cut the skin into small pieces.
  
  
  CONCLUSIONS
  Over-meshing a SSG can allow considerable further expansion, facilitating overgrafting of donor sites or simply increasing the area that can be covered with the existing harvested skin.
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Court Road, Chelmsford CM1 7TT, UK.
authors.forename: James
authors.initials: J
authors.lastname: Henderson
authors.forename: Reza
authors.initials: R
authors.lastname: Arya
authors.forename: Patrick
authors.initials: P
authors.lastname: Gillespie
mesh_terms: D000818:Animals; D012879:Skin Physiological Phenomena; D016038:Skin Transplantation / Q000295:instrumentation* / Q000379:methods*; D013526:Surgical Mesh; D013552:Swine