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  Abstract: Background. Recent studies have reported on the use of adipose derived regenerative cells (ADRC) as a therapeutic method in wound healing. The present study introduces the first application of successful ADRC therapy for a diabetic foot wound. Case Report. A 63-year-old woman with diabetes mellitus complaining of an opened necrotic wound in the plantar aspect of the right foot was admitted by another surgeon for debridement surgery. Despite multiple efforts, a Chopart’s amputation was performed to salvage rest of the foot. In the early postoperative period, a 2 cm x 2 cm circular ulcer at the heel region and a 1 cm x 2 cm unhealed wound at the previous incision site had formed. Due to resistant diabetic ulcers, the patient was introduced to ARDC therapy (informed consent was obtained). The Celusion System™ (Cytori Therapeutics, Inc, San Diego, CA) was used for autologous generation of ARDC cells—1 cc of the ARDC was mixed with 40 cc of fat graft. Afterward, the ARDC-enriched fat graft was introduced to the heel and plantar region to restore the deficient glabrous tissue. The remaining 4 cc of ARDC were equally injected in a radial fashion to the wound edges. Results. In the postoperative follow-up, accelerated wound healing was observed and the ulcers were completely healed after 4 weeks of ARDC treatment. Conclusion. ARDC therapy has the potential to be a promising new therapeutic modality for treating diabetic wounds.

Introduction

  Regenerative medicine points to the utilization of the body’s cells in the healing process. This fact has been introduced to a wide range of applications in which reconstructive surgery occupies an important space. Indeed cells, unlike many matrix molecules and proteins, cannot be manufactured per se. They must be harvested and replicated before clinical use. Moreover, this process must be performed in a manner such that the therapeutic potential of the cells is not dissipated.

  The therapeutic potential of using regenerative cells is tremendous. These cells have now been isolated in various tissues, and adipose tissue could be one of the most suitable and abundant cell sources for regenerative therapy.

  Recently, studies have shown the potential use of adipose derived regenerative cells (ADRC) as a therapeutic method in wound healing. In this article we introduce the first application of a successful ADRC therapy for a diabetic foot wound.

Case Report

  Another surgeon admitted a 63-year-old woman with diabetes mellitus for debridement surgery who had been complaining of an opened necrotic wound in the plantar aspect of her right foot. The patient was followed up for 45 days with the last 2 weeks for negative pressure wound therapy (V.A.C® Therapy, KCI, San Antonio, TX). Despite all attempts at treatment, the patient was still suffering from a high amount of yellow secretion, especially from the heel region. Culture swabs were obtained and all results were negative. A process of removing fat necrosis was continued and glabrous tissue in the heel region disappeared. The patient was then admitted to the authors' plastic surgery clinic, and after a through laboratory make-up, a Chopart’s type amputation was performed to salvage rest of the foot.