title: The real expansion rate of meshers and micrografts: things we should keep in mind.
abstract: Skin graft expansion techniques (mesh and micrograft) are widely used, but there is ample evidence that skin graft meshers do not provide their claimed expansion rates. Although this finding might not be new for the majority of surgeons, less is known about surgeons' actual knowledge of expansion rates. The aim of this study was to evaluate the true expansion rates of commonly used expansion techniques with regard to claimed, achieved, and polled results. In the first part of the study, 54 surgeons were polled during an annual burns meeting regarding the most commonly used expansion techniques and expansion ratios; in the second step the true (achievable) expansion rates of the most widely used meshers and micrografts were analysed; and in third step, a poll involving 40 surgeons was conducted to estimate the true expansion rates of the most frequently used skin expansion techniques. The skin meshers (1:1.5 / 1:3) did not achieve their claimed values: (1:1.5) 84.7% of the claimed expansion (mean ± SD: 1:1.27 ± 0.15) and (1:3) 53.1% of the 1:3 (1:1.59 ± 0.15) mesher. The use of the micrografting technique resulted in 99.8% of the 1:3 (1:2.99 ± 0.09), 93.6% of the 1:4 (1:3.74 ± 0.12) and 93.8% of the 1:6 (1:5.63 ± 0.12) claimed expansion rates, respectively. In general the surgeons overestimated the achievable expansion rates. In general the achieved expansion rate was lower than the estimated and claimed expansion rates. The micrografting technique provided reliable and valid expansion rates compared to the skin meshers. We recommend using the micrograft technique when large expansion ratios are required, for example in severe extensive burns.
authors: Division of Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Tissue Regeneration, Repair and Reconstruction, Department of Surgery, Medical University of Graz, Graz, Austria.
authors: L P
authors: LP
authors: Kamolz
authors: M
authors: M
authors: Schintler
authors: D
authors: D
authors: Parvizi
authors: H
authors: H
authors: Selig
authors: D B
authors: DB
authors: Lumenta
keywords: Meek’s technique; mesh; micrografting; skin graft; skin transplantation
references: Burns Incl Therm Inj. 1988 Jun;14(3):239-40
references: 3048568
references: J Burn Care Res. 2009 Mar-Apr;30(2):231-42
references: 19165111
references: Plast Reconstr Surg. 2011 Jul;128(1):40e-41e
references: 21701314
references: Burns. 2008 May;34(3):350-4
references: 17869002
references: Plast Reconstr Surg. 1997 Sep;100(3):653-6
references: 9283563
references: Burns. 1993 Apr;19(2):142-5
references: 8471149
references: Burns. 1997 Nov-Dec;23(7-8):604-7
references: 9568333
references: Burns. 2009 Dec;35(8):1071-9
references: 19520515
references: Hosp Top. 1965 Apr;43:114-6
references: 14265842
references: Burns. 1994 Jun;20(3):226-8
references: 8054134
references: Plast Reconstr Surg. 2010 Aug;126(2):492-498
references: 20375761
references: Burns. 1994;20 Suppl 1:S39-42
references: 8198741
references: Ann Plast Surg. 1993 Aug;31(2):162-3
references: 8215133
references: Acta Chir Plast. 1996;38(4):142-6
references: 9037792
references: Burns. 1995 Aug;21(5):364-70
references: 7546260