Platelet-Rich Plasma in a Refractory Venous Leg Ulcer Following Multiple Failed Skin Grafts

Chronic lower-extremity ulcers remain a major therapeutic challenge. Conventional treatments-including compression therapy, debridement, dressings, antibiotics, pharmacologic agents, hyperbaric oxygen, and skin grafting-frequently fail to provide durable closure, largely due to limited modulation of the wound-healing cascade. Autologous platelet-rich plasma (PRP) is gaining interest as a regenerative adjunct capable of delivering concentrated endogenous growth factors. We report a 58-year-old woman with more than 20 previous skin grafting procedures for recurrent lower-leg ulcers, arising from self-inflicted trauma and secondary infections. Multidisciplinary care of a 15 cm × 18 cm ulcer incorporating debridement, targeted antibiotics, and mainly PRP, administered in six sessions, contributed substantially to ulcer reduction and finally to complete wound healing. PRP has shown promise in enhancing wound closure rates, healing time, and tissue quality. However, the absence of standardized protocols for preparation, dosing, and application, as well as inconsistent outcome reporting, limits its broader adoption. This case underscores the potential role of PRP as a central component in managing complex, refractory ulcers, particularly when behavioural and infectious factors impede healing. Standardized protocols and robust clinical trials are warranted to clarify its role in chronic wound care.