Skin grafting with the modified Meek technique in the standing horse using full thickness skin: Evaluation of acceptance, wound contraction and wound closure in chronic wounds.
Authors: Wilmink Jacintha M, van Weeren P René
Journal: Equine veterinary journal
Summary
# Modified Meek Skin Grafting in Standing Horses: Making an Advanced Technique Practical Whilst the modified Meek technique produces superior results in equine wound management compared with conventional grafting methods, its clinical uptake has been limited by the requirement for specialised equipment and general anaesthesia. Wilmink and van Weeren simplified this approach by manually harvesting full-thickness skin grafts from the pectoral region and cutting them into micrografts without the full apparatus, allowing treatment of eight horses with chronic traumatic wounds over the carpus or tarsus whilst standing. Graft acceptance was remarkably high at 95.3%, with wound closure achieved through approximately equal contributions of contraction (46%) and epithelialisation (54%), resulting in 96.8% reduction of the original wound area by day 28. The resulting scars were flat, flexible and functionally sound, typically developing normal hair growth patterns, though the technique did demand increased manual skill with a learning curve during implementation. For practitioners managing chronic equine wounds, this adapted protocol offers an evidence-based alternative to second-intention healing that delivers excellent outcomes without the logistical and anaesthetic constraints previously associated with advanced grafting techniques.
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Practical Takeaways
- •The modified Meek technique can now be performed on standing horses using manual graft harvesting and cutting, making it accessible without expensive specialized equipment or general anaesthesia
- •Expect excellent graft acceptance (>95%) with full-thickness grafts from the pectoral area, resulting in fast healing (4 weeks) with superior cosmetic and functional outcomes compared to second intention healing
- •This technique is particularly valuable for chronic wounds on the dorsal carpus and tarsus that would otherwise heal with significant contraction and poor cosmetic results
Key Findings
- •Modified Meek technique with full-thickness skin grafts achieved 95.3% ± 2.5% graft acceptance in standing horses
- •Wounds closed in 28.0 ± 8.5 days with 96.8% ± 1.9% reduction in initial wound area through combined contraction (46%) and epithelialisation (54%)
- •Scars were flat, flexible, functional with regular hair growth, demonstrating cosmetically superior results
- •Adapted procedure eliminated need for expensive equipment and general anaesthesia while maintaining efficiency