Xie Yue,Ding Xionghui,Chen Qiang,et al.Research advances and applications of Meek micrografting in major pediatric burns[J].Journal of Clinical Pediatric Surgery,2022,21(03):288-291.[doi:10.3760/cma.j.cn101785-202005018-016]
MEEK微型皮片移植技术的研究进展及其在儿科领域的应用
- Title:
- Research advances and applications of Meek micrografting in major pediatric burns
- Keywords:
- Surgical Flaps/TR; Transplantation/MT; Transplants
- 摘要:
- 近年来儿童烧伤发病率持续升高,早期覆盖创面是治疗大面积烧伤的关键,然而儿童皮肤薄且供皮区少,容易形成瘢痕增生,如何增大皮片扩展比以及减少瘢痕增生是儿童烧伤创面修复的关键。MEEK微型皮片移植技术20世纪90年代起开始应用于临床,因其具有较高的扩展比、较短的手术时间及创面修复时间、较轻的瘢痕增生等优势,逐渐应用于烧伤创面覆盖。本文对MEEK微型皮片移植技术的临床应用及研究进展进行综述。
- Abstract:
- Recently the incidence of pediatric burns is continuously rising.As compared with adults, children tend to have a thinner skin and donor sites are relatively sparser.And subsequent scar hypertrophy also has a huge impact on their psychological and physical growth.An early coverage of wounds has become a key point of treating major burns.Meek micrografting technique was reapplied in clinical practice in 1990s.Due to its higher expansional ratio, shorter operative duration & wound repair time and minimal scar hypertrophy, this technique has achieved satisfactory outcomes.This review summarized the evolutions, principles, research advances and clinical applications of Meek micrografting technique in major pediatric burns.
参考文献/References:
[1] 何珊, 左泽兰.1946例住院烧伤患儿流行病学调查[J].中华烧伤杂志, 2018, 34(10):696-700.DOI:10.3760/cma.j.issn.1009-2587.2018.10.009.He S, Zuo ZL.Epidemiological investigation of 1946 hospitalized children with burns[J].Chin J Burns, 2018, 34(10):696-700.DOI:10.3760/cma.j.issn.1009-2587.2018.10.009.
[2] Medina A, Riegel T, Nystad D, et al.Modified meek micrografting technique for wound coverage in extensive burn injuries[J].J Burn Care Res, 2016, 37(5):305-313.DOI:10.1097/BCR.0000000000000244.
[3] Meek CP.Successful microderma grafting using the Meek-Wall microdermatome[J].Am J Surg, 1958, 96(4):557-558.DOI:10.1016/j.burns.2015.06.013.
[4] Keris RW, Mackie DP, Vloemans AW, et al.Widely expanded postage stamp skin grafts using a modified Meek technique in combination with an allograft overlay[J].Burns, 1993, 19(2):142-145.DOI:10.1016/0305-4179(93)90038-a.
[5] Lari AR, Gang RK.Expansion technique for skin grafts (Meek technique) in the treatment of severely burned patients[J].Burns, 2001, 27(1):61-66.DOI:10.1016/S0305-4179(00)00066-8.
[6] Dorai AA, Lim CK, Fareha AC, et al.Cultured epidermal autografts in combination with MEEK Micrografting technique in the treatment of major burn injuries[J].Med J Malaysia, 2008, 63(Suppl A):44.
[7] Hsieh CS, Schuong JY, Huang WS, et al.Five years’ experience of the modified Meek technique in the management of extensive burns[J].Burns, 2008, 34(3):350-354.DOI:10.1016/S0305-4179(00)00066-8.
[8] Medina A, Riegal T, Nystad D, et al.Wound coverage in major burns using the meek micrografting technique[J].J Burn Care Res, 2015, 36:S263.DOI:10.1097/BCR.0000000000000251.
[9] Almodumeegh A, Heidekrueger PI, Ninkovic M, et al.The MEEK technique:10-year experience at a tertiary burn centre[J].Int W Ound J, 2017, 14(4):601-605.DOI:10.1111/iwj.12650.
[10] Chong SJ, Choke A, Tan BK.Technical tips to enhance micrografting results in burn surgery[J].Burns, 2017, 43(5):983-986.DOI:10.1016/j.burns.2017.01.030.
[11] Menon S, Li Z, Harvey JG, et al.The use of the Meek technique in conjunction with cultured epithelial autograft in the management of major paediatric burns[J].Burns, 2013, 39(4):674-679.DOI:10.1016/j.burns.2012.09.009.
[12] 李亚南.Meek植皮术在小儿重度烧伤创面修复中的应用[J].安徽医科大学学报, 2013, 48(4):438-440.DOI:10.3969/j.issn.1006-2238.2009.12.028.Li YN.Meek dermoplasty for repairing children with severe deep burn wounds[J].Acta Universitatis Medicinalis Anhui, 2013, 48(4):438-440.DOI:10.3969/j.issn.1006-2238.2009.12.028.
[13] 夏照帆, 赵成跃.MEEK微型皮片移植技术临床操作规范[J].中华烧伤杂志, 2019, 28(1):73-78.DOI:10.3760/cma.j.issn.1009-2587.2019.08.001.Xia ZF, Zhao CY.Clinical operation procedure of grafting technique of MEEK micro-skin[J].Chinese Journal of Burns, 2019, 35(8):561-564.DOI:10.3760/cma.j.issn.1009-2587.2019.08.001.
[14] Roodbergen DT, Vlomans AF, Rashaan ZM, et al.The scalp as a donor site for skin grafting in burns:retrospective study on complications[J].Burns Trauma, 2016, 4:20.DOI:10.1186/s41038-016-0042-z.
[15] Culnan DM, Craft-Coffman, Bitz G, et al.Rapid communication:Solution for the MEEK glue transfer problem[J].J Burn Care Res, 2018, 39(2):274-277.DOI:10.1097/BCR.0000000000000587.
[16] 叶胜捷, 张文振, 陈如俊, 等.Meek植皮术修复儿童严重烧伤创面的效果[J].中华烧伤杂志, 2015, 31(4):264-266.DOI:10.3760/cma.j.issn.1009-2587.2015.04.006.Ye SJ, Zhang WZ, Chen RJ, et al.Meek skin grafts for repairing severe burns in children[J].Chin J Burns, 2015, 31(4):264-266.DOI:10.3760/cma.j.issn.1009-2587.2015.04.006.
[17] Peeters R, Hubens A.The mesh skin graft-true expansion rate[J].Burns Incl Therm Inj, 1988, 14(3):239-240.DOI:10.1016/0305-4179(88)90047-2.
[18] Lee SZ, Halim AS, Wan Sulaiman WA, et al.Outcome of the modified meek technique in the management of major pediatric burns[J].Ann Plast Surg, 2018, 81(3):295-301.DOI:10.1097/sap.0000000000001565.
[19] 应文杰, 王双双, 孙韬, 等.Meek植皮术和自体微粒皮联合异体大张皮移植术对大面积烧伤患者预后的比较[J].现代实用医学, 2020, 32(1):38-39.DOI:10.3969/.issn.1671-0800.2020.01.018.Ying WJ, Wang SS, Sun T, et al.Comparison of prognosis between Meek skin graft and autogenous microne skin plus allogeneic large skin in large area burn patients[J].Modern Practical Medicine, 2020, 32(1):38-39.DOI:10.3969/.issn, 1671-0800.2020.01.018.
[20] 金园园.Meek植皮术与邮票植皮术修复大面积烧伤创面的疗效及应用价值的Meta分析[J].河南外科学杂志, 2019, 25(4):6-9.DOI:10.16193/j.cnki.hnwk.2019.04.003.Jin YY.Meta-analysis of efficacy and application value of Meek skin grafting and stamp skin grafting in repairing large area burn wounds[J].Henan Journal of Surgery, 2019, 25(4):6-9.DOI:10.16193/j.cnki.hnwk.2019.04.003.
[21] Lari AR, Gang RK.Expansion technique for skin grafts (Meek technique) in the treatment of severely burned patients[J].Burns, 2001, 27(1):61-66.DOI:10.1016/S0305-4179(00)00066-8.
[22] Rode H, Martinez R, Potgieter D, et al.Experience and outcomes of micrografting for major paediatric burns[J].Burns, 2017, 43(5):1103-1110.DOI:10.1016/j.burns.2017.03.028.
[23] Lee SZ, Halim AS.Superior long term functional and scar outcome of Meek micrografting compared to conventional split thickness skin grafting in the management of burns[J].Burns, 2019, 45(6):1386-1400.DOI:10.1016/j.burns.2019.04.011.
[24] Rode H, Rogers AD, Martinez R.Overgranulation following meek micrografting:a possible solution[J].Burns, 2017, 43(7):1602-1604.DOI:10.1016/j.burns.2017.03.028.
[25] Houschyar KS, Tapking C, Nietzschmann I, et al.Five years experience with meek grafting in the management of extensive burns in an adult burn center[J].Plast Surg (Oakv), 2019, 27(1):44-48.DOI:10.1177/2292550318800331.
[26] 李峰, 王宏伟, 尹会男, 等.削痂后Ⅱ期于脂肪组织层行Meek植皮治疗大面积深度烧伤的临床效果及机制[J].中华烧伤杂志, 2019, 35(6):446-450.DOI:10.3760/cma.j.issn.1009-2587.2019.06.009.Li F, Wang HW, Yin KN, et al.Clinical effects and mechanism of treating extensive deep burns by staged Meek skin grafting on adipose tissue after tangential excision[J].Chinese Journal of Burns, 2019, 35(6):446-450.DOI:10.3760/cma.j.issn.1009-2587.2019.06.009.
[27] 李兴照, 蔡晨, 徐庆连, 等.重度烧伤患儿Meek微型皮片移植失败的原因及治疗措施[J].中华烧伤杂志, 2019, 35(7):525-531.DOI:10.3760/cma.j.issn.1009-2587.2019.07.009.Li XZ, Chen C, Xu QL, et al.Analysis of reasons for failure of Meek micro-skin grafting in children with severe burn and treatment measures[J].Chinese Journal of Burns, 2019, 35(7):525-531.DOI:10.3760/cma.j.issn.1009-2587.2019.07.009.
[28] 孟进松, 林国安, 李文军, 等.Meek植皮术联合悬浮床在小儿大面积深度烧伤中的应用研究[J].现代医药卫生, 2020, 36(6):887-888.DOI:10.3969/j.issn.10095519.2020.06.029.Meng JS, Lin GA, Li WJ, et al.Application of Meek skin graft plus floating bed in children with extensive deep burn[J].J Mod Med Health, 2020, 36(6):887-888.DOI:10.3969/j.issn.10095519.2020.06.029.
[29] 何学迅.Meek植皮联合重组牛碱性成纤维细胞生长因子外用凝胶治疗大面积烧伤临床研究[J].中外医学研究, 2019, 17(36):57-58.DOI:10.14033/j.cnki.cfmr.2019.36.024.He XX.Clinical study of Meek skin graft plus recombinant bovine basic fibroblast growth factor topical gel for extensive burn[J].Chinese and Foreign Medical Research, 2019, 17(36):57-59.DOI:10.14033/j.cnki.cfmr.2019.36.024.
[30] Zajicek R, Kubok R, Petrova N, et al.Complex approach to skin repair in an extensively burned child:a case study[J].J Wound Care, 2020, 29(8):458-463.DOI:10.12968/jpwc.2020.29.8.458.
备注/Memo
收稿日期:2020-05-08。
基金项目:重庆市自然科学基金(cstc2020jcyj-msxmx3026)
通讯作者:邱林,Email:qiulincqmu@aliyun.com