Platelet-rich plasma combined with a biodegradable scaffold enhances skin regeneration in diabetic wounds

Wound healing is a complex process involving inflammation, cell proliferation, angiogenesis, and extracellular matrix remodeling. This study aimed to evaluate the regenerative potential of a poly(glycerol sebacate)/poly(lactic acid) (PGS/PLA) scaffold incorporated with platelet-rich plasma (PRP) for full-thickness skin wound repair in rats. The scaffold was fabricated by electrospinning and applied to full-thickness excisional wounds in diabetic rats. Animals were divided into four groups: Control, Scaffold, PRP, and Scaffold-PRP. Wound area reduction was monitored and histological, stereological, molecular, and biomechanical analyses were performed to evaluate tissue regeneration. The Scaffold-PRP group demonstrated markedly accelerated wound closure compared to other groups at both day 4 and day 8 (P < 0.05). Stereological analysis revealed a significantly higher number of fibroblasts and blood vessels, along with a reduction in inflammatory cell infiltration in the Scaffold-PRP group, confirming enhanced granulation tissue formation and neovascularization. Masson's trichrome staining showed denser and more organized collagen deposition, while biomechanical testing indicated greater tensile strength of the repaired tissue, suggesting improved structural integrity. Moreover, ELISA results at day 8 showed that the levels of growth factors TGF-β1 and VEGF were significantly elevated, whereas pro-inflammatory cytokines TNF-α and IL-1β were markedly reduced in the Scaffold-PRP group compared with the controls (P < 0.05). In conclusion, the combination of PRP with the PGS/PLA scaffold synergistically enhanced wound healing by promoting angiogenesis, collagen synthesis, and tissue remodeling while attenuating inflammatory responses. This composite biomaterial represents a promising therapeutic platform for accelerating diabetic wound repair and improving the quality of regenerated skin.