Successful Fat Grafting in a Patient With Thromboangiitis Obliterans

Abstract

Thromboangiitis obliterans, or Buerger disease, is a rare nonatherosclerotic segmental inflammatory vasculitis that generally affects young tobacco smokers. Although no surgical treatment is available, the most effective way to halt the disease's progress is smoking cessation. In this case report, a 29-year-old smoker showed up to emergency department with gangrene of his fifth left toe and extensive plantar ulceration. After investigative angiography, he was diagnosed with Buerger disease. On November 2017, he underwent fifth left toe amputation and hyperbaric therapy. Five months after amputation, the patient was rehospitalized because of surgical wound dehiscence, wide ulceration, and pain. He was treated with lipofilling using the Coleman technique. Two weeks after the fat grafting procedure, the patient suspended pain control medication, and after 2 months, the surgical wound was almost healed. Fat grafting (lipofilling) is mostly used in plastic surgery; it offers regenerative effects, with minimal discomfort for the patient. This case report demonstrates a successful alternative use of lipofilling for this unique condition and opens up new options for use of this technique in other fields.

Application of nanofat grafting to rescue a severe ischaemic hand with thromboangiitis obliterans

“…Centrifuged native fat grafts were then harvested and inoculated 1 cm above the end of the terminal arteries. The dehiscent wound was almost healed at 60 days post procedure [9] . Kim et al [25] described that 72% (16 of 22 limbs) of autologous BMSC implantations in patients with TAO had angiogenesis with the growth of collateral vessels into distal lower limbs.…”

“…The dehiscent wound was almost healed at 60 days post procedure. [ 9 ] Kim et al [ 25 ] described that 72% (16 of 22 limbs) of autologous BMSC implantations in patients with TAO had angiogenesis with the growth of collateral vessels into distal lower limbs. Interestingly, in our case with centrifuged nanofat grafts as the source of ASCs, not only did the wound heal well, but the patency of previously occluded vessels was also noted.…”

“…Due to its regenerative abilities, nanofat is widely used clinically in the fields of wound healing and skin rejuvenation. [ 9 – 12 ]…”

“…Due to its regenerative abilities, nanofat is widely used clinically in the fields of wound healing and skin rejuvenation. [9][10][11][12] Fat extract has been proven to attenuate ischemic injury and stimulate angiogenesis in ischemic tissues. [13] In this case, we used nanofat grafting to treat severe conditions in a patient with TAO, with promising outcomes.…”

“…Procedure of nanofat grafting, first described by Tonnard et al, [8] allows quick isolation of ASCs from lipoaspirate. Due to its regenerative abilities, nanofat is widely used clinically in the fields of wound healing and skin rejuvenation [9–12] …”