[Seven cases of stage 4 pressure ulcers treated by conservative debridement combined with autologous small skin and/or microskin grafting on the hospital bed].

From June 2017 to October 2018, 7 patients with pressure ulcers were admitted to Taiyuan Ninth People's Hospital, including 3 males and 4 females, aged 75-86 years. There were totally 10 stage 4 pressure ulcer wounds without bone exposure, with wound area ranging from 6 cm×4 cm to 11 cm×9 cm. Three wounds were accompanied by latent cavity, with surface projection area of the latent space ranging from 5 cm×3 cm to 12 cm×8 cm. After admission, conservative debridement was performed continuously until the granulation tissue in the skin defect area was bright red, prone to bleeding, with basically flat base. The split-thickness skin of 1/4-1/2 of the wound area size was taken from the front side of the thigh on the hospital bed, and rectangular small skin with a side length of 1-3 mm and/or microskin were made and transplanted to the granulation wound. Conservative treatment was continued after the operation. Seven wounds healed 3-6 weeks after one transplantation. The sinus tract remained in the latent area of one wound 6 weeks after the first grafting, and the patient was discharged from hospital. One wound was grafted twice and healed 8 weeks after the first operation. One patient (one wound) died of underlying disease. This treatment method is suitable for stage 4 pressure ulcer wounds without bone exposure which cannot be operated on routinely, with small trauma, low risk, and being simple, and it can be performed on the hospital bed.