Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers

Background: Chronic ulcers have many bad impacts and are becoming an economic burden. Nanofat is rich origin of fatty-derived stem cells and different precursor cells. This work aimed to assess efficacy of nanofat injection in chronic ulcers and evaluating its effect on the healing process. Methods: This prospective randomized controlled study was carried out on 20 patients of both sexes aged between 18 - 60 years old with no co-morbidities. We included patients with chronic upper or lower extremity post-traumatic ulcers of 5 cm maximum diameter with no healing on conventional dressing for at least 3 months. Patients were randomly divided into two equal groups: group A (study group) was scheduled for nanofat injection and group B (control group) with conventional dressing with no plan for surgical intervention. Results: Vascularity, pigmentation, pliability and height were significantly improved in group A than group B. Time frame for complete healing was significantly delayed in group B than that of group A (median time for complete healing was 16.5 weeks and 3 weeks respectively). Patient satisfaction was significantly increased in group A than in group B. Skin biopsies showed that the epidermal thickness, dermal area % of collagen bundles and elastic fibres and the number of epidermal and dermal proliferating cell nuclei were significantly increased while the inflammatory cell count was markedly decreased in group A compared to ulcers of group B. Conclusions: Nanofat grafting may be a promising treatment option for patients with traumatic ulcers, as it can improve wound healing outcomes and patient satisfaction.