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Background <p>Adipose tissue represents a biological resource that supports wound healing through angiogenesis, immunomodulation, and tissue remodelling. It contains adipocytes, stromal vascular fraction, mesenchymal stem cell-like cells, and various growth factors. Clinical studies suggest that autologous fat grafting, particularly when combined with debridement, may improve healing in chronic wounds.This study aimed to evaluate the clinical efficacy of autologous fat grafting in chronic wounds of various etiologies and to investigate the prognostic value of systemic inflammatory indices (Platelet-to-Lymphocyte Ratio [PLR], Neutrophil-to-Lymphocyte Ratio [NLR], Systemic Immune-Inflammation Index [SII], and C-Reactive Protein–Albumin–Lymphocyte [CALLY] index) in the wound healing process.</p> Methods <p>This single-centre retrospective study included all patients who underwent autologous fat grafting for chronic wounds between January 2022 and January 2026. Of 40 screened patients, 14 were excluded, leaving 26 for the final analysis. Demographic, clinical, and laboratory data were recorded. Inflammatory indices were calculated from baseline laboratory parameters. Patients were divided into two groups—those with complete wound healing and those without—and compared.</p> Results <p>The mean age was 54.9 ± 14.4 years, and the mean time to complete wound healing was 57.0 ± 18.5 days. Complete wound healing was achieved in 84.6% of patients. In the non-healing group, neutrophil count (9.3 ± 5.5 vs. 5.2 ± 1.6; <i>p</i> = 0.008), PLR (287.2 ± 53.6 vs. 154.3 ± 68.8; <i>p</i> = 0.001), NLR (5.8 vs. 2.5; <i>p</i> = 0.031), and SII (2569 vs. 751; <i>p</i> = 0.031) were significantly higher, while haemoglobin levels were lower (10.2 ± 2.4 vs. 12.9 ± 2.2; <i>p</i> = 0.032). Initial wound area was also larger (<i>p</i> = 0.002), and the day-28 healing rate was significantly lower (28% vs. 79%; <i>p</i> = 0.005). No significant difference was observed in the CALLY index (<i>p</i> = 0.075).</p> Conclusions <p>Autologous fat grafting is an effective adjunctive treatment for chronic wounds. Systemic inflammatory indices, particularly PLR, NLR, and SII, may serve as potential, accessible, and cost-effective prognostic markers for predicting wound healing outcomes. Level IV, risk / prognostic study.</p>

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Autologous fat grafting in chronic wounds: prognostic value of systemic inflammatory indices from a single-centre experience

  • 期刊论文

  • 发表日期：

    2026年5月20日

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  • Ayhan Sonmez,
  • Metin Ocak,
  • Ismail Bulbuloglu,
  • Burak Bilgic,
  • Mehmet Iskenderoglu,
  • Burak Uyumaz,
  • Gulnur Ince,
  • Umut Tuncel

摘要

Background

Adipose tissue represents a biological resource that supports wound healing through angiogenesis, immunomodulation, and tissue remodelling. It contains adipocytes, stromal vascular fraction, mesenchymal stem cell-like cells, and various growth factors. Clinical studies suggest that autologous fat grafting, particularly when combined with debridement, may improve healing in chronic wounds.This study aimed to evaluate the clinical efficacy of autologous fat grafting in chronic wounds of various etiologies and to investigate the prognostic value of systemic inflammatory indices (Platelet-to-Lymphocyte Ratio [PLR], Neutrophil-to-Lymphocyte Ratio [NLR], Systemic Immune-Inflammation Index [SII], and C-Reactive Protein–Albumin–Lymphocyte [CALLY] index) in the wound healing process.

Methods

This single-centre retrospective study included all patients who underwent autologous fat grafting for chronic wounds between January 2022 and January 2026. Of 40 screened patients, 14 were excluded, leaving 26 for the final analysis. Demographic, clinical, and laboratory data were recorded. Inflammatory indices were calculated from baseline laboratory parameters. Patients were divided into two groups—those with complete wound healing and those without—and compared.

Results

The mean age was 54.9 ± 14.4 years, and the mean time to complete wound healing was 57.0 ± 18.5 days. Complete wound healing was achieved in 84.6% of patients. In the non-healing group, neutrophil count (9.3 ± 5.5 vs. 5.2 ± 1.6; p = 0.008), PLR (287.2 ± 53.6 vs. 154.3 ± 68.8; p = 0.001), NLR (5.8 vs. 2.5; p = 0.031), and SII (2569 vs. 751; p = 0.031) were significantly higher, while haemoglobin levels were lower (10.2 ± 2.4 vs. 12.9 ± 2.2; p = 0.032). Initial wound area was also larger (p = 0.002), and the day-28 healing rate was significantly lower (28% vs. 79%; p = 0.005). No significant difference was observed in the CALLY index (p = 0.075).

Conclusions

Autologous fat grafting is an effective adjunctive treatment for chronic wounds. Systemic inflammatory indices, particularly PLR, NLR, and SII, may serve as potential, accessible, and cost-effective prognostic markers for predicting wound healing outcomes. Level IV, risk / prognostic study.