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Débridement and Autologous Lipotransfer for Chronic Ulceration of the Diabetic Foot and Lower Limb Improves Wound Healing

Stasch, Tilman M.B.Ch.B., M.D.; Hoehne, Julius M.D.; Huynh, Tuan; De Baerdemaeker, Randy M.D.; Grandel, Siegfried M.D.; Herold, Christian M.D., Ph.D.

Plastic and Reconstructive Surgery: December 2015 - Volume 136 - Issue 6 - p 1357–1366
doi: 10.1097/PRS.0000000000001819
Reconstructive: Lower Extremity: Original Articles

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 becomes better known. The authors investigated the use of autologous lipotransfer for treatment of chronic diabetic and other foot and lower limb ulcers.

Methods: Twenty-six patients with nonhealing wounds were treated with surgical débridement and autologous lipotransfer (using the débridement and autologous lipotransfer method). The mean age of the wounds before intervention was 16.7 months. Wound size after débridement averaged 5.1 ± 2.6 cm2. On average, 7.1 ± 3.3 cc of lipoaspirate was transferred into the wound area.

Results: Twenty-two of 25 wounds (88 percent) 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 repeated session of lipotransfer led to complete wound healing after another 4 weeks.

Conclusion: 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.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Cologne, Aachen, and Hameln, Germany

From Valentis Beauty, Clinic for Aesthetic and Plastic Surgery; the Department of Plastic, Reconstructive and Aesthetic Surgery, Luisenhospital; and the Department of Plastic and Aesthetic Surgery, Handsurgery, Sana Klinikum Hameln Pyrmont.

Received for publication December 24, 2014; accepted July 30, 2015.

Presented at the Second International Society of Plastic Regenerative Surgery Congress, in Berlin, Germany, June 7 through 9, 2013.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Tilman Stasch, M.B.Ch.B., M.D., Valentis Beauty, Clinic for Aesthetic and Plastic Surgery, Kettengasse 10, 50672 Cologne, Germany, drstasch@gmail.com

©2015American Society of Plastic Surgeons