Fat Grafting (Autologous Lipotransfer) for Diabetic Foot Ulcers

NewsBot · Aug 18, 2015

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Debridement and Autologous Lipotransfer for Chronic Ulceration of the Diabetic Foot and Lower Limb improves Wound Healing (the DEALT Method).
Stasch, Tilman M.D., M.R.C.S. (Ed.), F EBOPRAS; Hoehne, Julius M.D.; Huynh, Tuan; Bardemaeker, Randy M.D.; Grandel, Siegfried M.D.; Herold, Christian M.D., Ph.D.
Plastic & Reconstructive Surgery: August 12, 2015

Background: The application of autologous lipotransfer (fat grafting, lipofilling) in reconstructive surgery is steadily becoming more popular as evidence of the regenerative and reparative effects of fat become evident. The authors investigated the use of autologous lipotransfer for treatment of chronic diabetic and other foot and lower limb ulcers.

Methods: 26 patients with non-healing wounds were treated with surgical debridement and autologous lipotransfer (using the DEALT Method). The mean age of the wounds before intervention was 16.7 months. Wound size after debridement averaged 5.1 +/- 2.6 cm2. On average, 7.1 +/- 3.3 cc of lipoaspirate was transferred into the wound area.

Results: 22 / 25 wounds (88 percent) of wounds healed completely within a mean of 68.0 +/- 33.0 days. A reduction of wound size by 50 percent was achieved after an average of 4 weeks. In one patient with an ulcer within particularly scarred tissues on the lower limb, a repeat session of lipotransfer lead to complete wound healing after another 4 weeks.

Conclusions: The authors describe a simple and useful technique to improve wound healing in diabetic feet and chronic lower limb ulcers with a background of peripheral vascular disease, where other interventional options to achieve wound healing have failed.
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NewsBot · Sep 7, 2023

Remission Strategies with Fat Grafting to Prevent Recurrence of Pedal Ulcerations and Pain: A Case Series
Gavin Thomas Kress et al
Plast Reconstr Surg Glob Open. 2023 Sep; 11(9): e5232.

Background:
Foot deformities and gait abnormalities can result in locally elevated peak pedal pressures or atypical pedal biomechanics. Combined with underlying comorbidities such as neuropathy, stroke, atrophic fat padding and history of ulcerations, this can lead to recurrent ulcerations and pain. Pedal fat grafting (PFG) is a treatment modality that has been shown to reduce peak pressures and accelerate wound healing. This study aimed to investigate the utility of PFG to treat and prevent ulcerations.

Methods:
We retrospectively analyzed medical history, demographics, wound volume at time of procedure, volume of fat injected, surgical outcomes, and presence of new wounds in 15 patients who underwent PFG at Keck Hospital between 2018 and 2023.

Results:
Seventeen feet from 15 patients (63 ± 12 years old, body mass index 30.9 ± 3.1) received PFG with an average volume of fat injected of 10.7 mL and procedure time of 84.6 minutes. At the time of PFG, nine wounds were present on nine feet with an average wound volume of 1.6 ± 2.7 cm3. Average follow-up was 6.9 months (range 1–36 months), with no complications or recurrent ulcerations since the procedure.

Conclusions:
PFG is a promising treatment option for reducing peak pedal pressure and preventing ulcer recurrence in patients with various conditions. Further study is warranted for long-term follow-up.
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