Autologous Adipose Tissue Graft to Treat Hypertensive Leg Ulcer: A Pilot Study

Abstract

Background: Adipose tissue is an abundant source of mesenchymal stem cells, called adipose-derived stem cells, which have anti-inflammatory and trophic effects to enhance overall tissue repair. Objective: To determine the healing effects of autologous adipose tissue graft on hypertensive leg ulcers. Methods: Prospective pilot study in 1 French dermatology department. Ten patients with a hypertensive leg ulcer were enrolled from April 2013 to June 2015. The primary end point was the wound closure rate at each follow-up visit. The secondary end points were wound characteristics, pain assessment and adverse events. Results: One patient, the only smoker, was lost to follow-up at month 5 (M5). For the 9 non-smokers, wound surfaces constantly and significantly decreased: the median wound closure rate was 73.2% at M3 and 93.1% at M6, p < 0.001. The median wound closure rate of the 10 patients was 63.2% at M3, p < 0.001. Percentages of fibrin and necrosis decreased, granulation tissue increased significantly. Pain rapidly and significantly decreased. No recurrence or adverse event was observed. Conclusion: Our data suggest that autologous adipose tissue grafting induces pain relief and promotes wound healing with a good skin quality. Large prospective controlled randomized studies are required to confirm these results.

A Systematic Review of Autologous Fat Grafting in the Treatment of Acute and Chronic Cutaneous Wounds

“…The average reduction in wound area was 85.7% in the only study where this was reported. 27 The average time to complete wound healing ranged from 4 to 16 weeks in the 2 studies where this was reported. 24 , 27 …”

“… 22 The average number of wounds completely healed at primary follow-up was 65% (40%–100%); however, this was only reported in 3 studies. 19 , 24 , 27 In the 2 studies where partial healing of wounds was reported, this was achieved in 22% 19 and 60% 27 of cases. The average reduction in wound area was 85.7% in the only study where this was reported.…”

“… 23 Five studies used the standard Coleman technique for lipotransfer, centrifuging harvested lipoaspirate at 3000–3500 rpm for 1–4 minutes. 19 , 20 , 22 , 24 , 27 …”

“… 18 – 20 , 24 – 26 Two studies injected both the wound edge and the base, 22 , 23 and 1 study used microinjections into the wound edge and the base. 27 One study injected CAL products into the base alone. 21 …”

Mechanical micronization of lipoaspirates for treatment of bleomycin-induced scleroderma in nude mice

“…Fat grafting has signi cant potential as a regenerative treatment in various diseases [3,4]. The therapeutic effect of fat grafting was also tested in scleroderma patients, identifying robust bene cial effects [5].…”