Wounds : a compendium of clinical research and practice · 2025
Fat pad augmentation using human adipose allograft yields durable closure in recalcitrant plantar ulcers.
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McGinness Kristen, Peck Brad, Javed Usman, Hitto Amer, Lundberg Torrin, Ricks Devin
Аннотация
BACKGROUND: Fat pad atrophy or migration leads to high pressure, a key factor in chronic plantar ulcer development. Current standard of care (SOC) only offers temporary pressure relief through off-loading, without addressing underlying fat pad defects.
OBJECTIVE: To assess the intraoperative use of human cryopreserved adipose tissue allograft (hCAT) alongside SOC for patients with chronic recalcitrant plantar ulcers persisting longer than 12 months.
MATERIALS AND METHODS: Eight patients with significant comorbidities, including diabetes mellitus, peripheral vascular disease, and chronic kidney disease, were included in this retrospective case series. The average ulcer size was 3.69 cm² (range, 0.14 cm²-20 cm²) with an average duration of 39.6 months (range, 21 months-59 months). Each patient underwent surgical debridement followed by hCAT implantation in the periwound area, followed by SOC. Outcomes included ulcer closure rate, time to closure, ulcer-free duration, and hCAT-related adverse events.
RESULTS: Seven patients (87.5%) achieved complete closure within 2.8 months on average (range, 0.8 months-7.2 months) with a post-closure ulcer-free duration averaging 5.6 months (range, 3.5 months-7.7 months) at the time of data analysis. No hCAT-related adverse events were observed. Patients are still being followed for longer-term outcomes.
CONCLUSION: These findings support hCAT as an effective adjunct to SOC in the management of chronic recalcitrant plantar ulcers.
OBJECTIVE: To assess the intraoperative use of human cryopreserved adipose tissue allograft (hCAT) alongside SOC for patients with chronic recalcitrant plantar ulcers persisting longer than 12 months.
MATERIALS AND METHODS: Eight patients with significant comorbidities, including diabetes mellitus, peripheral vascular disease, and chronic kidney disease, were included in this retrospective case series. The average ulcer size was 3.69 cm² (range, 0.14 cm²-20 cm²) with an average duration of 39.6 months (range, 21 months-59 months). Each patient underwent surgical debridement followed by hCAT implantation in the periwound area, followed by SOC. Outcomes included ulcer closure rate, time to closure, ulcer-free duration, and hCAT-related adverse events.
RESULTS: Seven patients (87.5%) achieved complete closure within 2.8 months on average (range, 0.8 months-7.2 months) with a post-closure ulcer-free duration averaging 5.6 months (range, 3.5 months-7.7 months) at the time of data analysis. No hCAT-related adverse events were observed. Patients are still being followed for longer-term outcomes.
CONCLUSION: These findings support hCAT as an effective adjunct to SOC in the management of chronic recalcitrant plantar ulcers.