An excellent method to cover large burns with a "true" expansion rate. Skin can be used from areas, having regenerated early like scrotum and multiple harvestings can be done by this

The position of meek technique in treatment of large burns presented at EBA in Lyon 2001

Meek is the best expansion technique in severely burned patients. If a mesh ratio of 1:3 or more is necessary than the the use of STSG's is cumbersome and healing with residual defects and hypergranulation is often the result. In these cases Meek with a ratio of 1:4 will do a lot better with finally superior functional and esthetic results.

Certainly one to have up your sleeve in the massive burn. The Chinese technique of micro skin grafting will achieve even greater expansion.

True, no question. But the feasibility in our centers is limited. Do you know anybody who does this technique in routine?

With the MEEK technique you can increase the ratio to a maximum of 1:9 which is huge. Will you obtain the same results (esthetic and functional) as with MEEK???

The way I see it is, beggars cannot be choosers. The best results obtained after split skin grafting are when one uses unmeshed sheet graft. We will be able to achieve this in the vast majority of our paediatric burns population. However my population mainly consists of children with small to medium sized burns. In the management of the massive burn, we do not have that luxury. The smaller one divides the graft and the farther these micro grafts are spaced apart, the worse will be the result. The Chinese technique of micrografting  certainly achieves the largest coverage per unit of SSG harvested , but as you can imagine the cosmetic and functional results  are often poor. I have spent time in several of the large burn institutes in China where at any one time they will have several >90-99% TBSA patients in the wards. They achieve a very high survival rate is very high in this group.