Skin micrografting in chronic wound therapy: from healing stimulation to infection control

Chronic soft tissue wounds represent one of the most pressing medical and social challenges in global healthcare. They are most common in older patients and in individuals with diabetes mellitus, chronic vascular disease, and post-traumatic conditions, including thermal injuries. The pathogenesis of such wounds is characterised by disruption of the physiological healing sequence, formation of microbial biofilms, and persistent inflammation, which markedly limits the effectiveness of conventional treatment strategies and contributes to an increased incidence of complications, disability, and mortality.

Split-thickness autologous skin grafting remains one of the most commonly used options for surgical wound closure. However, its use is limited by impaired vascularisation and infection of the recipient wound bed, which often leads to graft lysis. In this context, there is growing interest in skin micrografting—a group of techniques based on the use of skin microfragments, cell suspensions, and epidermal micrografts that can overcome existing limitations and thereby expand therapeutic options. These technologies provide high biological activity with minimal donor-site trauma and have the potential to activate neoangiogenesis, stimulate cellular proliferation, and remodulate chronic inflammation.

This review presents a systematic analysis of modern skin micrografting techniques, covering their clinical applications, current limitations, and potential for further development within pathogenetically grounded and personalised strategies for the chronic wound treatment.