IYSC08 - Extended Experience with 3D Bioprinted Autologous Adipose Tissue Grafts for Regeneration of Complex Lower Extremity Ulcers: Updated Results from a Chilean Cohort

Objectives: This study aimed to evaluate the early safety and clinical effectiveness of 3D bioprinted autologous micronized adipose tissue (MAT/MA-ECM/AMHAT) grafts for the treatment of complex chronic lower extremity ulcers, expanding upon our initial experience in a multicenter Chilean cohort.

Methods: A retrospective descriptive multicenter study was conducted including 17 patients with complex chronic lower extremity ulcers refractory to standard wound care. Ulcer complexity was defined as diabetic foot ulcers unresponsive to conventional therapy or with deep tissue exposure, chronic venous ulcers resistant to standard treatment, or arterial ulcers requiring minor amputation without the possibility of primary closure. Patients with active infection, previous major amputation, or uncontrolled systemic comorbidities were excluded. All patients underwent low-volume liposuction followed by mechanical processing of adipose tissue to obtain micronized adipose tissue. Customized grafts were generated through 3D bioprinting using the Dr. INVIVO platform with AI-assisted wound scanning. (1) Following meticulous surgical debridement, the bioprinted grafts were applied directly to the wound bed. Follow-up assessments were performed weekly for the first four weeks and bi-weekly thereafter until complete wound closure, with systematic documentation of healing progression and adverse events.

Results: The age of the patients ranged from 52 to 84 years. Diabetes mellitus was present in 16 patients (94.1%), and 15 patients (88.2%) had a history of revascularized occlusive arterial disease. Bone or joint exposure was observed in 12 patients (70.6%), while cavitated wound defects were present in 15 patients (88.2%). No serious adverse events related to the procedure or graft material were reported. Complete wound healing was achieved in 16 patients (94.1%), with a median time to closure of 98 days (range 30–152).

Conclusions: In this expanded multicenter Chilean experience, 3D bioprinted autologous adipose tissue grafting demonstrated a favorable safety profile and encouraging early regenerative outcomes in a highly complex wound population. (2) The high rate of complete healing and reproducible results across centers support the feasibility of this technology as an adjunctive regenerative therapy. Larger prospective controlled studies are warranted to confirm efficacy, optimize patient selection, and define its role in routine clinical practice.
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