title: Nanofat grafting under a split-thickness skin graft for problematic wound management.
abstract: BACKGROUND
  Obesity and certain medical disorders make the reconstruction of skin defects challenging. Different kind of procedure can be used for these defect, besides, skin grafting is one of the most common and simplest procedure. Fat grafting and stem cells which are located in the adipose tissue have been commonly used in plastic surgery for regeneration and rejuvenation purposes. To decrease graft failure rate we performed nanofat grafting under an autologous split-thickness skin graft in our patient who had a problematic wound.
  
  
  METHODS
  The case of a 35-year-old female patient with a traumatic skin defect on her left anterior crural region is described herein. After subsequent flap reconstruction, the result was disappointing and the defect size was widened. The defect was treated with combined grafting (nanofat grafting under an autologous split-thickness skin graft). At the 6 months follow-up assessment after combined grafting, the integrity of the skin graft was good with excellent pliability.
  
  
  CONCLUSIONS
  Combined grafting for problematic wounds seems to be a useful technique for cases requiring reconstruction. The potential existence of stem cells may be responsible for the successful result in our patient.
authors.affiliation: Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Erciyes University, Talas, Kayseri Turkey.
authors.forename: Cemal Alper
authors.initials: CA
authors.lastname: Kemaloğlu
keywords: Extremity reconstruction; Fat graft; Split-thickness skin graft; Stem cell