Clinical study of platelet-rich plasma in skin grafting of chronic ulcers in patients with diabetes

ZHAO Pengliang; CAO Yujue; YU Bin; ZHENG Jiefei; ZHU Haitao; MA Caihong; HOU Yusen

doi:10.3969/j.issn.1672-8521.2025.05.002

Abstract：Objective To investigate the clinical efficacy of platelet-rich plasma(PRP)combined with autologous ultra-thin skin graft transplantation in the treatment of chronic diabetic wounds.Methods Sixty patients with chronic diabetic wounds admitted to the Burn and Plastic Surgery Department of Beijing Fengtai You'anmen Hospital were selected from July 2021 to December 2022.They were randomly divided into an observation group(n=30)and a control group(n=30).The observation group prepared PRP with autologous blood and adopted the method of local spraying of PRP on the wound surface after debridement combined with autologous ultra-thin skin graft transplantation for repair,while the control group received autologous ultra-thin skin grafting after debridement.The survival status of skin grafts on postoperative days 3,7,and 14 were evaluated,the adhesion between the skin grafts and the wound were observed;observing whether the wound was infected,and the clinical efficacy of the two groups were calculated.The survival rate of the skin grafts and the healing time of the wound were calculated;adverse reactions during the treatment process were observed.Follow up for 3 months to observe the healing of the wound.Results No significant difference were observed between the two groups in terms of skin graft adherence rate and wound infection rate at 3 and 7 days(P>0.05).The skin graft adherence rate in the observation group after 14 days of treatment[96.67%(29/30)vs.70.00%(21/30);χ2=7.680,P<0.01]was significantly higher than that in the control group,and the wound infection rate was significantly lower than that in the control group[3.33(1/30)vs.26.67%(8/30);χ2=4.706,P<0.05].In the observation group,26 cases(86.67%)showed markedly effective,3 cases(10.00%)showed effective,and 1 case(3.33%)showed ineffective.In the control group,18 cases(60.00%)showed markedly effective,9 cases(30.00%)showed effective and 3 cases(10.00%)showed ineffective.The effect of skin grafting in the observation group was significantly better than that of the control group(Z=2.130,P<0.05).The healing time in the observation group was significantly shorter than that of the control group[(15.2±3.2)d vs.(24.5±4.8)d;t=8.200,P<0.001],14 days after the skin grafting,the graft survival rate in the observation group was significantly higher than the control group[(90.5±8.7)%vs.(63.5±12.3)%;t=-9.500,P<0.001].Conclusions PRP combined with autologous skin graft transplantation shows favorable efficacy in the treatment of diabetic chronic wounds,suggesting promising clinical application value.