# Selective enzymatic debridement and modified Meek technique in the treatment of extensive burns: Preliminary observations

## TL;DR

This study explores combining enzymatic debridement with the modified Meek technique to improve outcomes in patients with large burns.

## Contribution

The study introduces a synergistic approach using bromelain-based debridement and micro-grafting for extensive burns.

## Key findings

- Combined enzymatic debridement and modified Meek technique improved scar quality in burn patients.
- Nine patients with burns over 20% TBSA were treated successfully with this method.
- Local infections were the main complication, but most patients survived with better aesthetic outcomes.

## Abstract

Selective bromelain‐based enzymatic debridement (BED) has emerged as a valid alternative for the treatment of extensive burns, with Total Body Surface Area (TBSA) > 20%. Autologous skin grafting represents the procedure of choice but the scarcity of donor sites remains the main reconstructive challenge. The modified Meek micro‐grafting technique may represent a valid strategy to optimize the final outcome.

A single‐cohort retrospective analysis was performed, involving nine burn patients (TBSA > 20%) who underwent both BED and subsequently modified Meek technique. Demographic and clinical data (mechanism of injury, surgical treatment, complications, necessity of re‐grafting, further surgery and esthetic outcome) were collected.

All patients had large burns of mixed and deep dermal thickness (first, second, and third degree). All burns were enzymatically debrided postadmission and covered by the modified Meek technique. Local infection due to poor general conditions was the main complication for all patients. All but two patients survived. The selectiveness of the enzymatic debridement and dermal preservation seemed to improve the quality of scars resulting from micro‐grafting. Evaluations performed at 12 ± 2 months postburn showed superior scar quality compared to areas treated with traditional (sheet/mesh) grafts.

Combined BED and Meek techniques may provide an effective synergic combination for the treatment of extensive burns.

Combined bromelain‐based enzymatic debridement and Meek techniques may provide an effective synergic combination for the treatment of extensive burns, implying superior scar quality.Nine burn patients were evaluated, demographic, epidemiological and clinical data were collected.The selectiveness of the enzymatic debridement and dermal preservation seemed to improve the quality of scars resulting from micro‐grafting.

Combined bromelain‐based enzymatic debridement and Meek techniques may provide an effective synergic combination for the treatment of extensive burns, implying superior scar quality.

Nine burn patients were evaluated, demographic, epidemiological and clinical data were collected.

The selectiveness of the enzymatic debridement and dermal preservation seemed to improve the quality of scars resulting from micro‐grafting.