Background
Martorell’s ulcers are common in hypertensive patients and are characterized by painful ulceration on the distal aspect of the leg. Traditionally, management has involved surgical debridement followed by eventual wound closure. In this study, we share our experience treating patients with woundectomy followed by fat lipoaspirate and skin grafting.

Objective
The aim of this audit was to evaluate the management of Martorell’s ulcers using woundectomy followed by fat injection and skin grafting.

Methodology
Patients with histologically confirmed Martorell’s ulcers were followed up between January 2017 and December 2022. Woundectomy was performed, after which fat lipoaspirate was infiltrated into the wound bed. The wounds were dressed with conventional dressing materials for at least two weeks, after which skin grafting was carried out. Postoperatively, patients were reviewed at regular intervals over one year to assess recurrence.

Results
A total of 28 patients with histologically confirmed Martorell’s ulcers were included, of whom 18 were female. Two patients had ulcers on both legs. Pain scores significantly improved, reducing from an average of 8/10 before treatment to 2/10 after fat grafting. All patients achieved good skin graft take. Recurrence of the ulcer was noted in only one patient during the one-year follow-up period.

Conclusion
Woundectomy followed by fat lipoaspirate infiltration and skin grafting is a reliable method for treating Martorell’s ulcers. This technique provides significant pain relief, promotes wound healing, and demonstrates low recurrence rates, making it a valuable addition to the armamentarium for managing Martorell’s ulcers.