Exploring the Role of Fat Grafting As an Adjunct in the Treatment of Chronic Leg Ulcers in Plastic Surgery: A Comparative Analysis of Techniques

Abstract

Fat grafting has emerged as a promising adjunctive therapy in the treatment of chronic leg ulcers. This review explores various fat grafting techniques, such as traditional lipofilling, microfat grafting, and nanofat grafting, to evaluate their efficacy, safety, and cost-effectiveness in promoting wound healing. Nanofat grafting, with its higher concentration of adipose-derived stem cells (ascs), offers superior therapeutic outcomes, including enhanced tissue regeneration, better scar remodeling, and faster healing times compared to other methods. The review highlights the critical roles of ascs in angiogenesis, immunomodulation, and collagen synthesis, providing insight into the biological mechanisms underlying the success of fat grafting. Despite the technical and patient-related challenges in clinical practice, fat grafting has demonstrated a healing rate of 80-90%, with lower complication rates and higher long-term volume retention. This scoping review identifies key areas for further research, including long-term outcome studies and the standardization of fat grafting techniques, to enhance its clinical application in wound management.