Costs and Health Outcomes of Meek Skin Micrografting vs. Mesh Skin Grafting in Adult Patients With Deep Partial Thickness and/or Full-Thickness Small (Burn) Wounds
Author(s)
Tijs Van Iseghem, MSc1, Nick Verhaeghe, MSc, PhD2, Ruben Paul Willems, MSc, PhD3.
1PhD student, Ghent University, Ghent, Belgium, 2Ghent University, Ghent, Belgium, 3Ghent University, Gent, Belgium.
1PhD student, Ghent University, Ghent, Belgium, 2Ghent University, Ghent, Belgium, 3Ghent University, Gent, Belgium.
OBJECTIVES: The aim of this study was to assess costs and health outcomes of the Meek skin micrograft technique compared to the Meshed skin graft technique in patients with small skin defects, deep partial thickness and/or full thickness burns requiring surgery.
METHODS: A multicentre, prospective, randomized, intra-individual clinical trial was conducted in Belgium and The Netherlands from 2021 to 2023. Expansion ratios in both techniques were 1:2 for burns or other skin defects < 11% total body surface area (TBSA) and 1:3 in patients with burns or other skin defects between 11% and 20% TBSA. Health-related quality of life was measured by the EQ-5D-5L and the Dermatology Life Quality Index (DLQI). Other variables of interest were: skin graft harvesting time, total operating time, material costs, days to complete wound healing, and re-operations.
RESULTS: Per protocol analysis included 70 patients, of which 60 received the 1:2 expansion. No significant differences were found for EQ-5D-5L utility or DLQI scores. Patients with 1:3 Mesh expansion rates had higher though insignificant utility scores at three months compared to the 1:3 Meek expansion group (0.579 vs. 0.681, p=0.45), but ultimately, no difference was observed at twelve months. The operating time was longer for Meek (30.7±1.8 minutes) compared to Mesh (17.6±1.6 minutes) the 1:2 expansion group, and 41.4±7.2 minutes vs. 22.2±5.6 minutes for the 1:3 expansion group. The number of days to complete wound healing was higher for Meek (35±2.3 vs. 30±2.3). Out of ten reoperations, none were performed on Mesh only.
CONCLUSIONS: Health-related quality of life did not differ significantly between Meek micrografting and Mesh grafting. The analysis suggests that a 1:3 Mesh expansion may facilitate more rapid short-term recovery compared to 1:3 Meek micrografting, with no substantial differences observed in long-term outcomes. Other variables indicated the Meek micrografting technique is likely to incur higher costs.
METHODS: A multicentre, prospective, randomized, intra-individual clinical trial was conducted in Belgium and The Netherlands from 2021 to 2023. Expansion ratios in both techniques were 1:2 for burns or other skin defects < 11% total body surface area (TBSA) and 1:3 in patients with burns or other skin defects between 11% and 20% TBSA. Health-related quality of life was measured by the EQ-5D-5L and the Dermatology Life Quality Index (DLQI). Other variables of interest were: skin graft harvesting time, total operating time, material costs, days to complete wound healing, and re-operations.
RESULTS: Per protocol analysis included 70 patients, of which 60 received the 1:2 expansion. No significant differences were found for EQ-5D-5L utility or DLQI scores. Patients with 1:3 Mesh expansion rates had higher though insignificant utility scores at three months compared to the 1:3 Meek expansion group (0.579 vs. 0.681, p=0.45), but ultimately, no difference was observed at twelve months. The operating time was longer for Meek (30.7±1.8 minutes) compared to Mesh (17.6±1.6 minutes) the 1:2 expansion group, and 41.4±7.2 minutes vs. 22.2±5.6 minutes for the 1:3 expansion group. The number of days to complete wound healing was higher for Meek (35±2.3 vs. 30±2.3). Out of ten reoperations, none were performed on Mesh only.
CONCLUSIONS: Health-related quality of life did not differ significantly between Meek micrografting and Mesh grafting. The analysis suggests that a 1:3 Mesh expansion may facilitate more rapid short-term recovery compared to 1:3 Meek micrografting, with no substantial differences observed in long-term outcomes. Other variables indicated the Meek micrografting technique is likely to incur higher costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE285
Topic
Clinical Outcomes, Economic Evaluation, Medical Technologies
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Injury & Trauma, No Additional Disease & Conditions/Specialized Treatment Areas, Sensory System Disorders (Ear, Eye, Dental, Skin), Surgery