To explore the clinical therapeutic effect of PRP on refractory wounds in orthopedics department. Methods A total of 30 patients with refractory wounds admitted to Junan County People's Hospital from May 2019 to May 2023 were selected as the research objects. According to the random lottery method, they were divided into control group and study group, with 15 patients in each group. The control group was treated with simple skin grafting, and the study group was treated with PRP combined with skin grafting. The clinical efficacy, serum inflammatory factor level, pain, wound healing time and hospitalization time were compared between the two groups. Results The total effective rate of the study group was 93.33%, which was higher than 60.00% of the control group (P <0.05). The levels of CRP, IL-6 and TNF-α in the two groups after treatment were lower than those before treatment, and those in the study group were lower than those in the control group (P <0.05). The pain score of the two groups after treatment was lower than that before treatment, and that in the study group was lower than that in the control group (P <0.05). The wound healing time and hospitalization time of the study group were shorter than those of the control group (P <0.05). Conclusion PRP combined with skin grafting is more effective in the treatment of refractory wounds, which is helpful to relieve pain, reduce inflammation, accelerate wound healing, and is worthy of clinical application.