To explore the effect of platelet-rich plasma (PRP) combined with micro-skin transplantation in the treatment of chronic small wounds in the elderly in plateau area.

From February 2018 to February 2022, sixty elderly patients with chronic minor wounds were selected from Department of Burns and Plastic Surgery, Qinghai Provincial People′s Hospital. Patients were divided into observation group and control group according to the time of admission. The observation group was treated with PRP combined with micro-skin graft, while the control group was treated with PRP combined with blade-thick mail-like skin graft. The peripheral venous blood of patients was collected and PRP was prepared by secondary centrifugation. Under local infiltration anesthesia, all patients in the two groups used an electric skin-taking machine to take a skin piece with a suitable size and a blade thickness of about 0.2 mm from the front inner thigh according to the needs of the wound. The ratio of donor and recipient areas in the observation group was 1∶4 to 1∶8, and the taken skin piece was cut into small pieces with a diameter of < 1 mm for later use. In the control group, the ratio of donor and recipient areas was 1∶1 to 1∶2, and the skin graft was made into mail-like skin with blade thickness of about 1 cm×1 cm for later use. After wound debridement and hemostasis, the observation group evenly smeared the prepared micro-particle skin on the wound, then filled the wound with PRP, covered the wound with polyurethane foam dressing or vaseline gauze to avoid the loss and inactivation of PRP, and covered and fixed with clean dressing; in the control group, the prepared PRP was filled in the wound surface, and then the prepared blade-thick mail-like skin graft was transplanted on the PRP, and the cleaning dressing was covered with vaseline or polyurethane foam dressing for pressure dressing. Both groups were routinely treated with anti-infection therapy after operation, and the wound was changed on the 6th, 11th, 16th, 21st and 26th day after operation until the wound was completely healed. On the 21st day after operation, the effective rate of treatment in the two groups was counted. The wound healing time of the two groups was counted; six months after wound healing, the scars of the two groups were evaluated by Vancouver scar scale(VSS). The data were compared by Mann-Whitney U test and chi-square test.

On the 21st day after operation, 27 cases were effective and 3 cases were ineffective in the observation group, and the effective rate was 90.00%. In the control group, 20 cases were effective, 10 cases were ineffective, and the effective rate was 66.67%. The difference between the two groups was statistically significant (χ²= 6.278, P=0.043). The wound healing time in the observation group was 26.0 (24.0, 27.0) d, which was shorter than that in the control group [43.0 (39.8, 47.3) d], and the difference between the two groups was statistically significant (Z=-6.531, P<0.05). Six months after wound healing, the VSS scores of hyperpigmentation, scar thickness, vascular distribution and flexibility in the observation group were 0 (0, 0), 0 (0, 0), 0 (0, 0), 0 (0, 0), 1 (0, 1) points, respectively, which were lower than those in the control group [2.0 (1.0, 2.3), 1.5 (0.8, 2.0), 1 (1, 2). 2 (1, 3) points], there were statistically significant differences between the two groups (Z=-6.310, -4.838, -5.624, -4.431; P< 0.05).

In plateau area, the innovative technology of PRP combined with micro-skin can improve the effective rate of treatment, shorten the healing time of wounds, and provide patients with more healing options.