Composite fat and skin grafting for the management of chronic sickle cell ulcers

Lower extremity ulcers affect 8%-10% of individuals with sickle cell disease. The pathogenesis of this condition is poorly understood, and a good option for the long-term management of these lesions does not exist. Skin grafting and local wound care remain the mainstay of treatment; however, even short-term success often leads to long-term failure, as the wound might once again breakdown. The authors postulated that successful long-term healing of a chronic sickle cell leg ulcer would require a permanent alteration of the wound bed with recruitment of a new cell population. To this end, a skin graft, in conjunction with fat grafting, was performed for the treatment of a chronic sickle cell ulcer that had previously failed under local wound care and skin grafting treatments. .