Prevention of pressure sore recurrence with fat graft: Outcome analysis with recurrence, thickness, and scar. A pilot study.

Background: Pressure ulcers are a common and debilitating complication in patients with spinal cord injuries (SCI), often requiring reconstructive surgery. However, scarred areas remain vulnerable to recurrence. This study evaluates lipografting as a secondary prevention strategy to enhance soft tissue padding over bony prominences and reduce ulcer recurrence. Additionally, it investigates whether fat resorption rates are higher in compromised tissue. Methods: Five wheelchair-bound male patients with SCI who had previously undergone reconstructive surgery for ischial pressure sores were included. Lipografting was performed, and soft tissue thickness was measured using ultrasonography preoperatively, immediately postoperatively, and at 3 and 12 months. Scar pliability, patient satisfaction, and fat resorption rates in the compromised area were also assessed. Results: Significant soft tissue augmentation was observed immediately postoperatively, with an average retention rate of 60.7% at one year. Scar pliability improved in all patients, and no new pressure ulcers developed during the follow-up period. Patients reported high satisfaction, with one noting increased tolerance for prolonged sitting. Conclusion: Lipografting appears to be a promising, minimally invasive approach for secondary prevention of pressure ulcer recurrence in SCI patients. While these findings are encouraging, further studies with larger cohorts and longer follow-up are necessary to confirm the long-term benefits of this technique.