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

Background: 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. Case Presentation: 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. Conclusion: 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.