The modified Meek technique as a novel method for skin grafting in horses: evaluation of acceptance, wound contraction and closure in chronic wounds.
Authors: Wilmink J M, van den Boom R, van Weeren P R, Barneveld A
Journal: Equine veterinary journal
Summary
Chronic limb wounds in horses frequently fail to heal satisfactorily, partly because traditional skin grafting techniques struggle to succeed in the inflammatory environment inherent to second-intention healing; this research investigated whether the modified Meek technique—a method proven effective in infected and inflamed human burn wounds—might overcome these limitations in equine patients. The team evaluated graft acceptance, wound contraction, and closure rates using the modified Meek approach, which produces multiple small island grafts from a single donor site, thereby maximising surface coverage whilst minimising donor site morbidity. Results demonstrated improved graft acceptance with this technique compared to conventional meshed sheet grafts, particularly in horses where chronic inflammation and infection had compromised healing. For practitioners managing difficult equine wounds, particularly those on the limbs where movement and persistent inflammation typically doom traditional grafting attempts, the modified Meek technique represents a potentially valuable alternative that warrants consideration as part of a staged wound management protocol. Understanding graft biology in the context of equine-specific inflammatory responses may help farriers, veterinary surgeons, and rehabilitation specialists make more informed decisions about which wounds are candidates for grafting and when intervention is most likely to succeed.
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Practical Takeaways
- •Consider the modified Meek technique for difficult-to-heal chronic limb wounds in horses where standard meshed grafts have failed, as it may have better success rates in inflamed tissue
- •Manage chronic inflammation aggressively in wound cases destined for grafting, as inflammation is a key barrier to graft acceptance in equine patients
- •Modified Meek grafting may improve cosmetic outcomes over conventional techniques in horses with chronic wound healing problems
Key Findings
- •Modified Meek technique island skin grafts showed better acceptance in horses compared to meshed sheet skin grafts in chronically inflamed wounds
- •Chronic inflammation during second intention healing of equine limb wounds is a major cause of graft failure
- •Movement and infection remain significant factors contributing to graft failure in equine skin grafting