Preliminary results of the new lipogluing technique plus full-thickness skin graft in post traumatic lower limb reconstructive surgery

Abstract

Soft tissue reconstruction of a complex wound in the lower leg still presents a challenge to reconstructive surgeons, especially in the foot and ankle with exposed bones. We report the preliminary results of soft tissue complex defect treatment and coverage with our new lipogluing technique plus full-thickness skin graft. From September 2015, five patients with complex soft tissue defects on the lower leg underwent the coverage procedure with our new lipogluing technique plus full-thickness skin graft. At the first surgical step after standard debridement, we fix by fibrin glue the graft of fat cells withdrawn using the standard Coleman technique. Lipoglued fat cells enhance the soft tissue cover and better supplement the final skin thickness and pliability. This allows us to achieve the ultimate goal of reconstructive procedures: the recreation of all anatomical cutaneous and subcutaneous layers. Based on this preliminary personal experience, reliable information can be given about the safety, effectiveness, and usefulness of the lipogluing technique plus skin graft. All patients were able to wear normal footwear and to return to their usual activities thanks to the good results obtained and, when necessary, to thin coverage. To date, the coverage appears durable on all patients and they do not show any secondary problems of skin ulceration or breakdown. The lipogluing technique represents an evolution of the reconstructive process that aims to augment the autologous soft tissue under the skin graft avoiding more invasive procedure, in order to obtain a skin cover that feels natural. Level of Evidence: Level V, therapeutic study.