Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

Abstract

Autologous fat transfer may offer a simple and effective treatment option for chronic wound patients, delivering adipose-derived stem cells, with potent regenerative attributes. Nevertheless, the clinical benefit has not yet been sufficiently demonstrated. A total of 39 wound patients were treated with autologous fat transfer (AFT) and matched with a control group, according to the identified confounding variables “gender” and “method of defect closure.” All data were acquired retrospectively. Primary outcome was “wound closure” and “reduction of wound size.” After a follow-up of 48 weeks, there was no significant difference in primary outcome (wound closure P = .54) between both groups. The relative wound reduction after fat transfer was 69.9% ± 42.7% compared to 53.4% ± 106.8% in the control group ( P = .91). Subgroup analysis of all patients, healed by secondary intention, revealed an increased wound size reduction ( P = .03) and wound closure rate ( P = .20) in the case group after 12 weeks. No adverse events were recorded. Fat grafting can reduce the wound size if left to secondary healing and may be considered individually for reconstructive purposes. A repeated application of autologous fat might be beneficial due to a temporary effect.

Sublesional fat grafting leads to a temporary improvement of wound healing in chronic leg ulcers: A prospective, randomised clinical trial

“…Despite this limited number of available RCT's, the hypothesis of a temporary effect on wound healing and therefore an acceleration of the healing process seems to be evident and is supported by previous results of our working group 23 . Neovascularization is an important process in wound healing.…”

“…Despite this limited number of available RCT's, the hypothesis of a temporary effect on wound healing and therefore an acceleration of the healing process seems to be evident and is supported by previous results of our working group. 23 Neovascularization is an important treatment of non-healing diabetic foot ulcers using a protocol with MSC application on Day 0 and again after 5 weeks. 24 They described the most pronounced absolute wound surface area reduction 2 weeks after each single application.…”

“…The measured wound size after surgical debridement (Day 0) was defined as 100% (Figure 1). Therefore, the mean wound size increased by 18.6% in the intervention group and by 23…”

Application of Adipose-Tissue Derived Products for Burn Wound Healing

“…Previous clinical studies have reported that autologous fat grafting may accelerate healing in chronically scarred tissue resulting from chronic wounds and radiation-induced soft tissue injury [ 28 , 29 ]. In the field of burn treatment, fat grafting has shown promising outcomes as an adjuvant therapy by promoting wound healing, reducing the typical healing time, and minimizing the occurrence of hypertrophic scarring [ 30 ].…”