Platelet-Rich Plasma (PRP)-Assisted Full-Thickness Skin Grafting for Tendon-Exposed Foot Wound in a Diabetic Patient: A Case Report

Traumatic foot wounds in patients with diabetes mellitus pose significant reconstructive challenges, especially when tendon exposure limits the feasibility of simple closure techniques and advanced microsurgical options are not available in low-resource settings. Platelet-rich plasma (PRP) is increasingly used as an adjunct to enhance wound bed quality by supporting tissue regeneration and vascularization, potentially improving the success of grafting procedures. We present the case of a 63-year-old man with type 2 diabetes mellitus who sustained a traumatic dorsal foot wound with exposed extensor tendons and was managed with serial wound care and three applications of activated PRP, resulting in progressive granulation tissue formation and improved vascularity. Definitive coverage was achieved using a manually harvested, fenestrated full-thickness skin graft (FTSG) from the medial aspect of the left arm in a resource-limited hospital setting, with primary closure of the donor site. A small central area of partial graft necrosis healed by secondary intention, and complete graft take was ultimately achieved. This case illustrates how PRP-assisted wound bed optimization can facilitate successful FTSG coverage of tendon-exposed traumatic defects in diabetic patients when more complex reconstructive options are unavailable, offering a practical solution in environments with limited resources.