Meek微型皮片移植技术的临床应用

目的探讨Meek微型皮片移植技术（M法）在创面中的应用。方法用M法在9例烧伤和1例坏死性筋膜炎所致创面中的应用。M法植皮面积2％～28％,其中1例23％TBSA和5％腹壁供皮区,平均面积8．6％,4例切（削）痂后即刻用该法进行植皮;4例在切（削）痂后第4～16天用M法进行植皮;2例在伤后第35～45天形成的肉芽创面用M法进行植皮;M法中应用1：4扩展纱布42张,1：6扩展纱布40张,1：9扩展纱布26张。在应用M法同时,在同一个体进行人工邮票皮片移植5例,微粒皮移植4例,网状皮（1：1）移植1例。结果应用M法的病例手术时间为9～60min;8例皮片100％成活,1例80％、1例50％成活,平均93％;其他植皮方法手术时间是30～240min,成活率为100％的2例、90％～98％的4例、80％的3例、50％的1例,平均86％。结论Meek植皮术适用于体表任何形式的创面（骨外露创面除外）,尤其是大面积烧伤病员;创面皮片上皮化时间短;皮片的的扩展率,根据创面大小,选择不同比例的扩展纱布,因此皮片用量少;手术时间缩短;工作人员劳动强度降低。

Clinical application of Meek micrograft technique

OBJECTIVE: To explore the clinical application of the transplantation of the Meek autograft. METHODS: Meek autografts were transplanted on the full-thickness wounds of 10 patients, including 9 cases of burn and 1 case of necrofascitis, with the area of 8.6% (2% - 28%) of the total body surface, and the average of the area was. Meek skin graft was placed on the wounds immediately after escharectomy (in 4 cases), 4 - 16 days after tangential excision (in 4 cases), or on the clean wound granulation 35 - 45 days after the injury (in 2 cases). 108 pieces of extending gauze of different rates were used. As comparison, Stamp-like grafts, micrografts, or net-like graft were used in different places of the same bodies in 5, 4, and 1 case respectively. RESULTS: The operation time of Meek micrograft technique was 9 - 60 minutes. The survival rate of the Meek graft was 93% (100% in 8 cases for, 80% in 1 case, and 50% in 1 case). The operation time of the other operation techniques was 30 - 240 minutes. The average survival rate of the other operation techniques was 86% (100% in 2 cases, 90% - 98% in 4 cases, 80% in 3 cases, and 50% in 1 case). CONCLUSION: Meek autograft is suitable for all of the full-thickness wound except bone-exposure wound, including the wound of major burns. This technique uses less skin to repair the wound and the time for epithelization is shorter than that of the traditional methods. The staff and time needed for the operation are less. The outcome is good and the healed wound is fine-looking.