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The Use of Fat Grafting for Non-Healing Wounds – a Systematic Review of the Literature
Fanru Shen, MD, Sara Yacoub, B.A., Elad Fraiman, B.A., MPH, Ana E.S.H.Vieira, MD, Eliana F.R. Duraes, MD, PhD
Hospital center training program
2025-01-09
Presenter: Fanru Shen, MD
Affidavit:
Data collection was performed by Sara Yacoub, Elad Fraiman, Dr Shen and Dr Vieria and analysis was performed by Sara Yacoub under supervision of Dr.Duraes.
Director Name: Eliana F.R. Duraes, MD, PhD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: Non-healing acute and chronic wounds, particularly those exposing deep structures greatly affect patient morbidity, healthcare costs, and quality of life. Autologous fat grafting, rich in adipose-derived stem cells and growth factors, shows promise as a regenerative therapy for wound healing. This systematic review evaluates the efficacy, safety, and quality of evidence supporting autologous fat grafting in wound management.
Methods: A comprehensive search of PubMed, Medline, and Embase (2014–2024) identified studies on fat grafting for non-healing wounds. Inclusion criteria encompassed human studies treating open wounds with autologous lipotransfer, with or without stromal vascular fraction, adipose-derived stem cells, or platelet-rich plasma. The American Society of Plastic Surgeons Rating Levels of Evidence and Grading system was used to assess the evidence.
Results: Out of 4,711 citations, 35 studies on fat grafting for non-healing wounds were included. 12 were randomized controlled trials, 4 cohort studies, 1 case-control study, and 18 case reports or series. Diabetic foot wounds represent the most common etiology. Treatment involves wound debridement, the Coleman technique and dressing application. Autologous fat grafting consistently proved effective for covering tissue, preparing wound beds for skin grafting, and reducing healing time. The evidence included 12 level 2 studies and 5 level 3 studies.
Conclusion: Preliminary evidence indicates that fat grafting holds potential as an effective treatment for non-healing wounds, offering reliable coverage for exposed critical structures. However, further research is needed to identify optimal wound types, session frequency, and graft volume. A large-scale randomized controlled trial is essential to develop an evidence-based guidelines.
