Is nanofat the long-awaited treatment for hypertensive ischemic leg ulcers?

Abstract

Background: Martorell hypertensive ischemic leg ulcer (HYTILU) is a chronic, hard-to-heal wound linked to hypertension. This study explores nanofat grafting as a regenerative alternative to traditional skin grafting for improved healing and patient outcomes.

Objective: To explore the efficacy of nanofat grafting in the management of HYTILU and compare it with skin grafting.

Materials and methods: This was a retrospective single-center pilot study involving 23 patients with HYTILU treated with adipose-derived stromal cells (adipose-derived stromal cells/nanofat). The primary outcomes were ulcer healing rate, pain reduction, and improvements in quality of life, as measured by SCAR-Q (a scar quality of life questionnaire) and the Vancouver Scar Scale, over a period of 6 months posttreatment.

Results: This study revealed a significant decrease in ulcer size from an initial mean of 39.69 cm² to complete healing, with an average healing time of 4.65 months. The mean visual analog scale pain scores significantly decreased from an initial score of 5.87 to 0.39 at 3 months postinjection (P < .0001). Quality of life was significantly improved after treatment, as underscored by higher SCAR-Q scores and lower Vancouver scale scores, indicating better scar quality and minimal adverse effects.

Conclusion: These study results underscore nanofat grafting as a superior alternative to traditional skin grafting for HYTILU, offering advantages in terms of healing time, pain management, and patient quality of life. Further research is needed to confirm these findings and assess the use of nanofat in the management of other chronic wounds.