Staged Biodegradable Temporizing Matrix and Meek Micrografting as a Donor-Sparing Strategy for Extensive Burn Injuries.

Abstract

Definitive closure of extensive burns remains constrained by donor-site availability, particularly in patients with burns of 50% total body surface area (TBSA) or greater. Biodegradable Temporizing Matrix (BTM) can stabilize excised wounds while donor sites recover, whereas Meek micrografting permits controlled expansion of limited autologous skin. We retrospectively reviewed adult patients admitted between May 2022 and May 2025 with burns of 50% TBSA or greater who underwent BTM application followed by Meek micrografting as part of definitive wound-closure management. Demographic, injury, operative, and outcome variables were collected from electronic medical records, operative reports, anesthesia records, wound-care documentation, and clinical photography when available. Twelve patients were included. Mean age was 41.5 years, mean burn size was 63.1% TBSA, and mean Baux score was 104.6. All patients had inhalation injury and required tracheostomy. BTM was applied at a mean of 13.3 days after admission, and Meek micrografting was performed at a mean of 42.2 days. Mean TBSA covered by Meek micrografting was 32.5%, representing 50.6% of the burn surface. Operative efficiency improved from 15.2 to approximately 10.8 minutes per 1% TBSA covered over the study period. Clinically documented Meek graft take exceeded 90% in evaluable cases, no patient required secondary autografting of Meek-grafted BTM areas, and 11 of 12 survived to discharge or inpatient rehabilitation. Staged BTM followed by Meek micrografting is a feasible donor-sparing strategy for extensive burn closure that permits special-area prioritization, donor-site recovery, and efficient definitive coverage of large prepared wound surfaces.