Background. Martorell hypertensive ischemic leg ulcer (HYTILU) is a chronic, hard-to-heal wound linked to hypertension. This study explores nanofat grafting as a regenerative alternative to traditional skin grafting for improved healing and patient outcomes. Objective. To explore the efficacy of nanofat grafting in the management of HYTILU and compare it with skin grafting. Materials and Methods. This was a retrospective single-center pilot study involving 23 patients with HYTILU treated with adipose-derived stromal cells (adipose-derived stromal cells/nanofat). The primary outcomes were ulcer healing rate, pain reduction, and improvements in quality of life, as measured by SCAR-Q (a scar quality of life questionnaire) and the Vancouver Scar Scale, over a period of 6 months posttreatment. Results. This study revealed a significant decrease in ulcer size from an initial mean of 39.69 cm² to complete healing, with an average healing time of 4.65 months. The mean visual analog scale pain scores significantly decreased from an initial score of 5.87 to 0.39 at 3 months …. read more