Comparative study between skin micrografting (Meek technique) and meshed skin grafts in paediatric burns

•Meek technique is valuable for treating paediatric burns.•Meek micrografts achieve their targeted expansion rates.•Meek micrografts combat infection better than meshed grafts.•Meek technique can use tiny parts skin grafts and expand them.•Meshed skin grafts are cheaper than the meek grafts and easier to learn. Globally, burn injuries are the 3rd principal cause of death due to injury among children aged 1–9 years. Yet, the management of paediatric burns is always challenging; due to limited donor sites and the cosmetic appearance that will affect the child later in life, either at the donor or the recipient site. Skin grafts may need to be expanded to minimise donor skin size or in patients with limited donor sites. Multiple techniques were described for graft expansion, mainly the mesher and the Meek technique. A prospective comparative randomised study was done from January 2019 to June 2020 on 40 paediatric burn patients with deep dermal and full-thickness burns. Patients were divided into two groups, Meek and meshed groups. The skin graft take, epithelialization time, total time of the surgery and the aesthetic outcomes (using the POSAS – Patient and observer scar assessment scale) in each group were evaluated at three months postoperatively. The percentage of take in the Meek group (84.25%) was significantly better than with the meshed group (71.5%) (P = 0.006). Epithelialization time was better for the Meek group (27.11 days) compared to the meshed group (33.5 days) (P = 0.176). In addition, infection rates were lower in the Meek group (25%) than the meshed group (40%) (P = 0.311). Subjectively POSAS scar assessment scale exhibited better results for the Meek group with a mean score of 3.17 & for the meshed group was 4.2 (P = 0.048). The observer’s overall score was as well better for the Meek group with a mean overall opinion score of 2.89 & for the meshed group was 4.1 (P = 0.003). The operative time was longer with the Meek technique than the traditional mesher (P