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Case Reports in Dermatological Medicine
Volume 2016 (2016), Article ID 7685939, 4 pages
Case Report

Treatment of a Refractory Skin Ulcer Using Punch Graft and Autologous Platelet-Rich Plasma

1Department of Dermatologic Surgery, Centro Ortopedico di Quadrante Hospital, 28882 Omegna, Italy
2Department of Orthopedics, Centro Ortopedico di Quadrante Hospital, 28882 Omegna, Italy
3Department of Medicine, Centro Ortopedico di Quadrante Hospital, 28882 Omegna, Italy
4Department of Metabolic Disease and Diabetology, ASL VCO, 28925 Verbania, Italy

Received 3 November 2015; Accepted 21 January 2016

Academic Editor: Elizabeth Helen Kemp

Copyright © 2016 Mauro Carducci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Chronic ulceration of the lower legs is a relatively common condition amongst adults: one that causes pain and social distress and results in considerable healthcare and personal costs. The technique of punch grafting offers an alternative approach to the treatment of ulcers of the lower limbs. Objective. Combining platelet-rich plasma and skin graft enhances the efficacy of treating chronic diabetic wounds by enhancing healing rate and decreasing recurrence rate. Platelet-rich plasma could, by stimulating dermal regeneration, increase the take rate after skin grafting or speed up reepithelialization. Methods and Materials. The ulcer was prepared by removing fibrin with a curette and the edges of the ulcer were freshened. The platelet-rich plasma has been infiltrated on the bottom and edges of the ulcer. The punch grafts were placed in 5 mm holes arranged. The ulcer was medicated with hydrogel and a pressure dressing was removed after 8 days. Results. After a few days the patient did not report more pain. Granulation tissue appeared quickly between implants. Most of the grafts were viable in 2-3 weeks. The grafts gradually came together to close the ulcer and were completed in four months.