How to Use a Skin Graft Mesher: A Theatre Nurse and Surgeon Checklist

Before the case: equipment checks

Confirm that the mesher, the carrier or plate set and the cutting roller are the ones intended for the planned ratio, and that the packs are sterile and in date. Inspect the roller for visible damage or residue, check that the handle or drive turns freely, and place the device on a stable, dry surface at a comfortable working height.

Always read the manufacturer's IFU for your model. If your theatre uses a Zimmer device, the Zimmer skin graft mesher IFU is the authoritative document for it; the NOUVAG Mesher has its own instructions, and the steps below are generic.

Meshing a skin graft: the basic sequence

After the surgeon has harvested the split-thickness graft, usually with a dermatome, keep it moist and flat. Lay it on the carrier plate with the orientation specified in your IFU, smoothing out folds so that the whole graft is supported with no overhang that could jam in the rollers.

Feed the carrier with the graft into the mesher and turn the drive in one smooth movement. Avoid stopping mid-way, because a pause can produce an uneven pattern. Retrieve the carrier from the exit side and check the pattern for completeness before you remove the graft.

• Check pack integrity, plate and roller before opening
• Keep the graft moist and flat on the carrier
• Feed straight and turn the drive evenly without stopping
• Inspect the pattern before the graft leaves the carrier

Expansion and how a skin graft is attached

Once meshed, the graft can be gently stretched in width so the pattern opens and the graft covers a larger area. The surgeon places it on the prepared wound bed and fixes it according to local practice and the wound, for example with sutures or staples, with a dressing placed on top. How the graft is attached is a clinical decision.

The meshed graft is a mesh because the open spaces let fluid escape and the graft conform to uneven areas. Read more about this in our articles on meshed split-thickness skin grafts and sheet graft vs mesh graft.

Common mistakes

The most frequent problems are a dry graft that sticks to the carrier, folds that jam the rollers, using the wrong plate for the planned ratio, forcing the drive when the graft is not fed straight and not inspecting the roller after previous use. Another is leaving the roller wet after cleaning, which can corrode it over time.

A short pre-case briefing between scrub nurse and surgeon, naming the ratio and the plate, prevents most of these errors.

Cleaning and maintenance after the case

Clean the device immediately so that blood and tissue cannot dry on it. The knife roller of the NOUVAG Mesher is removable for maintenance and cleaning. Follow the IFU for cleaning agents and sterilisation cycles, dry all parts thoroughly and store plates flat.

Log the number of uses per roller and plate so that your biomedical team can inspect or replace wearing parts on schedule. For more on selecting plates and carriers, see skin graft mesher carriers.

Training and support

Beckfinity can arrange hands-on training on the NOUVAG Mesher for your theatre staff. Request a session and tell us which team members should attend.