The Modified Meek Technique – where are we now?

Relative to its potential, the use of skin grafts for treating equine wounds is still limited. A survey under ECVS and ACVS equine specialists in 2008 revealed that grafting in general is not popular because of the unpredictable acceptance of the various types of grafts whereas the final cosmetic result appeared regularly disappointing. Additionally, the costs of surgery were often seen as a reason not to perform a skin graft.

The Modified Meek technique is the newest technique for skin grafting in horses and this technique is clinically evaluated.¹ The technique appears to give consistent and reliable results. The acceptance of thick partial thickness micrografts is nearly 95% and is reported to be better than that achieved with any other type of skin grafting performed in horses. High numbers of islands can be easily applied, up to thousands, which means that large wounds can be grafted. Most wounds that receive Meek micrografts heal within a month, regardless of the wound’s size and location whereas the functional and cosmetic results are consistently good.¹The micrografts enhance wound contraction to approximately 300% more than contraction of deep experimental limb wounds in horses during second-intention healing.² These effects are hypothesized to result from the action of cytokines present in the dermis of the grafts. Although any type of graft that includes the dermis may have such effect, dermal contact with the wound after Meek micro-grafting is greater than after the other types of island grafting because of the high number of islands that can be easily applied and because the grafts are split-thickness. The increase in wound contraction means a reduction in the size of the final scar.

Despite the simple surgery and the superior results of the Modified Meek technique, the technique is so far not extensively used. One of the reasons seems the reluctance of clinics to invest in the equipment, being the dermatome to harvest the partial thickness skin and Meek machine to cut the skin in islands. An additional reason is the requirement of general anesthesia to harvest partial thickness skin, because that part of the surgery is very painful. [...]