ADIPOSE RECONSTRUCTION FOR DIABETIC FOOT OFF-LOADING

Diabetic foot ulcers occur due to local increases in pressure, neuropathy and lack of blood flow. Elevated glucose levels can increase these issues leading to ulcerations. Poor shock absorption and high peak pressures lead to tissue breakdown and ulcerations can form. 

Normal care in wound healing suggests offloading of wounds when abnormal pressures exist which help allow for healing. Standard offloading include: knee high ankle immobilizing boots or total contact casts. In some cases, the lack of cushion and shock absorption quality can be addressed by using adipose tissue. 

Allogenous adipose matrix injections are newer to the market - Leneva, MTF biologics. Using these reduces risks of harvesting and reduces chances of inflammation.

Autogenous adipose transfers can be from any part of the body but posterior calf is the simplest.

Courtesy of Barry Block, editor of PM News