Innovative Regenerative Treatment with Nanofat Injection for Hypertensive Ischemic Leg Ulcer: A Case Report

Martorell's ulcer, also known as hypertensive ischemic leg ulcer (HYTILU) or Martorell hypertensive ischemic ulcer, presents significant therapeutic challenges. The regenerative potential of nanofat, derived from adipose tissue, offers a promising therapeutic option.

We describe a 75-year-old female patient with a chronic ischemic ulcer measuring 30.1 cm² and persisting for more than 5 years. The patient had longstanding hypertension, controlled with three antihypertensive medications, and type 2 diabetes mellitus with microangiopathy. A single injection of 5 mL nanofat, prepared using the Tonnard technique, was administered intradermally at the wound site. Within 3 months, the ulcer surface reduced by 70%, achieving complete healing at 6 months. Pain management was significantly improved, with the visual analog scale (VAS) decreasing from 8/10 to 0/10 within 7 days. Quality of life, assessed using the Nottingham Health Profile and SCAR-Q, showed remarkable improvement. No adverse events were noted.

This case shows how nanofat can promote quick healing, relieve pain, and improve quality of life in a chronic ischemic wound. It offers a safe, minimally invasive, and effective alternative to traditional treatments. More research is needed to validate these results.