545 Meek Micrografting and a Bioabsorbable Scaffold for Skin Coverage in Extensive Burn Injuries
Bibliographic record
Abstract
Abstract Introduction The management of burn injuries over 50% of the body surface area requires a reliable and reproducible strategy to enhance healing and obtain satisfactory outcomes. This paper explores the application of Meek Micrografting and a bioabsorbable scaffold as a comprehensive treatment approach for these patients at an American Burn Association verified Burn center. Methods All patients admitted with full thickness flame burn injuries over 50% TBSA who underwent application of the bioabsorbable scaffold (BS) and Meek micrografting over a two- year period, were included in the study. Data collected included patient demographics, co-morbidities, mechanism and extent of burn injury, surgical approach and hospital course, as well as complications. Results Eleven adult patients were included in this retrospective study (Table). Their mean age was 43.2 years (range 21-72 years) and all but three were male. Their mean TBSA burn was 61.2% (range 50 -74%), with Inhalation injury grade of 2.1 and Baux score of 108.3 (range 86-137). Mean length of stay was 66.5 days (range 44-80), and 8.3 surgeries (range 6-12) were undertaken. Tracheostomy was performed at a mean of 17.2 days. The Meek surgery was usually the final surgery and was performed at a mean of 42.1 days (range 35 – 53 days) after admission. The BS and Meek strategy covered almost half of the burn surface area (mean 29.5% TBSA, or 45.5% of the burn). The 3:1 expansion ratio was used in all patients. The average operative time used per % TBSA covered decreased over the period, with 15.18 minutes per % TBSA during the initial five cases, and 10.8 minutes during the second six cases (p = 0.03). One patient required partial removal of the BS for MRSA infection. Micrograft take exceeded 90% in all cases, and no further autografting was undertaken. All but one of the patients survived to discharge after a period of inpatient rehabilitation. Conclusions The bioabsorbable scaffold (BS) provides Meek micrografts with a stable, homogenous, well vascularized and therefore receptive wound bed. We present a series of eleven patients with extensive burns who received the combination of these two strategies to good effect. Applicability of Research to Practice With greater experience, burn operating teams can reduce operative time per TBSA covered and obtain excellent outcomes using 3:1 Meek on the wound bed provided by the boabsorbable scaffold. Funding for the Study N/A
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".