Refractory wounds are generally defined as wounds that persistently do not heal or heal slowly for various reasons and are difficult to heal completely with routine dressing changes. With the development of society, chronic diseases and geriatric diseases are increasing year by year, and refractory wounds are becoming more and more common, which is a clinical problem often faced by plastic surgery. Systemic factors include: diabetes, rheumatic immune diseases, blood diseases, malnutrition, etc. Local factors include: infection, gravitational compression, vasculitis, radiation damage, arteriosclerosis occlusive disease, etc. To treat difficult-to-heal wounds, we should try to treat the cause of the disease and improve local nutrition and blood supply. For example, if atherosclerotic occlusive disease causes difficult to heal wounds, vascular surgery can be performed to improve the distal blood flow, thus promoting the healing of the wounds. However, in many cases, the lesions caused by primary diseases are difficult to heal, such as diabetes mellitus and rheumatic immune diseases, which require a combination of treatments to promote wound healing. Commonly used methods: local medication (growth factors, antibacterial drugs, traditional Chinese medicine, hypertonic preparations), new dressings (hydrocolloid dressing, hydrogel dressing, alginate dressing), systemic medication (drugs to improve blood supply, growth hormone, nutritional drugs, antibacterial drugs, etc.), surgical treatment (skin graft, flap, debridement, etc.).