Objective To assess the clinical efficacy of Shengji Xiangpi Plaster（生肌象皮膏） combing punctuate skin grafting in treating refractory wounds and to explore the potential mechanism. Methods A total of 48 cases with refractory wounds were selected and randomly divided into Shengji Xiangpi Plaster group and Vaseline group

with 24 cases in each group. After the patient’ s wound bed was fully prepared

the punctate skin graft was carried out. In the Shengji Xiangpi Plaster group

the wound was covered with a single layer of Shengji Xiangpi Plaster

and the Vaseline group was covered with Vaseline gauze

and then wrapped with sterile dry gauze. After that

the Shengji Xiangpi Plaster gauze or Vaseline gauze was replaced every other day until it was completely healed. The survival rate and healing time of the skin grafts were observed. At the same time

wound secretions were collected on the 0

2 nd

4 th

6 th and 8 th day after skin grafting. The tumor necrosis factor α（TNF-α） and interleukin-1β（IL-1β）

transforming growth factor β1（TGF-β1） and vascular endothelial growth factor（VEGF） contents were detected. Results The skin graft survival rate of the Shengji Xiangpi Plaster group was 93. 78 ± 4. 87%

and the Vaseline group was82. 37 ± 3. 19%. There was statistical difference in the skin graft survival rate of two groups（P < 0. 05）. Compared with baseline

the levels of TNF-α

IL-1β

TGF-β1 and VEGF were significantly increased in the two groups on the4 th and 6 th day（P < 0. 05）. Compared with the Vaseline group

the levels of TNF-α and IL-1β of Shengji Xiangpi Plaster group were decreased on the 6 th and 8 th day

and the levels of TGF-β1 and VEGF were higher than those of Vaseline on the 4 th

6 th and 8 th day（P < 0. 05）. Conclusion Shengji Xiangpi Plaster combing punctuate skin grafting can increase the survival rate of the skin. The mechanism may be to reduce the inflammatory reaction after skin grafting and promote the formation of new capillary and neoplastic epithelium.