Kress Gavin Thomas, Swerdlow Mark, Mohan Natasha, Patel Ketan, Shin Laura
From Keck School of Medicine of the University of Southern California (USC), Los Angeles, Calif.
Department of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2023 Sep 1;11(9):e5232. doi: 10.1097/GOX.0000000000005232. eCollection 2023 Sep.
Foot deformities and gait abnormalities can result in locally elevated peak pedal pressures or atypical pedal biomechanics. Combined with underlying comorbidities such as neuropathy, stroke, atrophic fat padding and history of ulcerations, this can lead to recurrent ulcerations and pain. Pedal fat grafting (PFG) is a treatment modality that has been shown to reduce peak pressures and accelerate wound healing. This study aimed to investigate the utility of PFG to treat and prevent ulcerations.
We retrospectively analyzed medical history, demographics, wound volume at time of procedure, volume of fat injected, surgical outcomes, and presence of new wounds in 15 patients who underwent PFG at Keck Hospital between 2018 and 2023.
Seventeen feet from 15 patients (63 ± 12 years old, body mass index 30.9 ± 3.1) received PFG with an average volume of fat injected of 10.7 mL and procedure time of 84.6 minutes. At the time of PFG, nine wounds were present on nine feet with an average wound volume of 1.6 ± 2.7 cm. Average follow-up was 6.9 months (range 1-36 months), with no complications or recurrent ulcerations since the procedure.
PFG is a promising treatment option for reducing peak pedal pressure and preventing ulcer recurrence in patients with various conditions. Further study is warranted for long-term follow-up.
足部畸形和步态异常可导致局部峰值踏板压力升高或非典型踏板生物力学。再加上潜在的合并症，如神经病变、中风、萎缩性脂肪垫和溃疡病史，这可能导致复发性溃疡和疼痛。足部脂肪移植（PFG）是一种已被证明可降低峰值压力并加速伤口愈合的治疗方式。本研究旨在探讨PFG治疗和预防溃疡的效用。
我们回顾性分析了2018年至2023年在凯克医院接受PFG的15例患者的病史、人口统计学、手术时的伤口体积、注射的脂肪体积、手术结果以及新伤口的情况。
15例患者（63±12岁，体重指数30.9±3.1）的17只脚接受了PFG，平均注射脂肪体积为10.7 mL，手术时间为84.6分钟。在进行PFG时，9只脚上有9处伤口，平均伤口体积为1.6±2.7 cm。平均随访6.9个月（范围1 - 36个月），自手术以来无并发症或复发性溃疡。
PFG是一种有前景的治疗选择，可降低各种情况下患者的峰值踏板压力并预防溃疡复发。有必要进行进一步的长期随访研究。
