In 1958 a remarkable technique for expanding autografts was described by C.P. Meek. With a MEEK-WALL dermatome postage stamp autografts were obtained and expanded using double pleated gauzes. In this way a regular distribution of autograft islands was achieved with a nine fold expansion. This technique however required too much skill and it became eclipsed by the introduction of mesh skin grafts (Tanner et al., 1964). Eventually production of the MEEK-WALL dermatome and gauzes was discontinued.

However, lack of autograft donor sides is increasingly encountered as a limiting factor in achieving wound closure in case of extensive skin defects. The Meshgraft technique requires donor sites of suitable size and shape and epithelialization may be delayed with expansion ratios greater than 1:4. Besides widely expanded meshed autografts might become unmanageable.

In cooperation with surgeons of the burn centre of the Red Cross Hospital Beverwijk, The Netherlands, Humeca re-designed and modernized the MEEK technique. Imperfections of the original method were overcome and the prefolded gauzes are now manufactured with expansion ratios 1:3, 1:4, 1:6 and 1:9.

The clinical results with this modified MEEK technique are excellent: the graft take appears to be superior to other methods, even in problematic zones and even in case of qualitatively inferior wound beds. Only very small donorsites are required. Any small piece of patients skin can be used. The graft islands are close together in a regular pattern, resulting in fast epithelialization. As the autograft islands are not mutually connected, failure of a few islands does not necessarily affect the overall graft take.