To investigate the clinical efficacy of full-thickness microskin grafting in the treatment of autoimmune disease-related ulcers.

A retrospective study was conducted on 28 patients with autoimmune disease-related ulcers admitted to the Department of Burns and Plastic Surgery, Air Force Medical Center from January 2018 to June 2024. All patients were treated with wound vacuum drainage， debridement and dressing change after admission， and skin grafting was performed when the wound was clean and bacteria culture was negative， including 11 patients with full-thickness microskin grafting and 17 patients with split-thickness skin grafting. Statistically analyzed and compared the two skin grafting methods in terms of operation duration， postoperative 24 h blood loss at the skin donor site （the number of gauze layers visibly soaked with blood）， pain degree of skin donor site［visual analogue scale （VAS）］ at first dressing change， skin grafted area and skin donor site healing time， Vancouver scar scale （VSS） score at 6 months after healing of the skin grafted area and skin donor site， and patient treatment satisfaction （evaluated by Likert 5-point scale）.

There was no significant difference in the operation time between the full-thickness microskin grafting group 2 （1.5， 2.0） hours and the split-thickness skin grafting group 2 （1.5， 2.0） hours （P>0.05）. The blood loss in 24 h in the full-thickness microskin grafting group ［（2.10±0.82） layers］ was significantly lower than that in the split-thickness skin grafting group ［（12.27±3.71 ） layers］（t=8.896， P<0.001）. At the same time， the VAS score of full-thickness microskin grafting group ［（2.24±0.41） points］ was significantly lower than that of split-thickness skin grafting group ［（6.51±1.23）points］at the donor site at the first dressing change （t=11.059， P<0.001）. The healing time of donor site in full-thickness microskin grafting group ［（10.45±1.56）d］was significantly shorter than that in split-thickness skin grafting group ［（19.48±3.75）d］ （t=7.536， P<0.001）. The wound healing time in full-thickness microskin grafting group was （32.13±5.79） d, which was significantly higher than that of split-thickness skin grafting group （25.53±7.37 d） （t=2.506， P<0.05）. In 6 months after healing， the wound VSS score of full-thickness microskin group was （3.18±1.37）points， which was significantly lower than （4.52±1.06） points of split-thickness skin graft group （t=2.913， P<0.01）. The VSS of donor site in full-thickness microskin group was （2.31±1.19） points in 6 months after healing， which was much lower than （4.11±1.42） points in split-thickness skin graft group （t=3.481， P<0.01）. There was no significant difference in treatment satisfaction between the two groups （P>0.05）.

The full-thickness microskin grafting is minimally invasive， economical， and simple for the treatment of AID-related ulcers. It can significantly reduce pain and bleeding at the donor site， accelerate the healing of the donor site， and reduce scar at the donor site and wound after healing.