Background: There is limited number of report related to the direct use of non-centrifuged adipose graft in the literature. This preliminary study aims to present our experience on the efficacy of non-centrifuged autologous fat graft use in the treatment of lower extremity wounds. Methods: 16 wounds treated with non-centrifuged autologous fat grafts were retrospectively analyzed. VAC (vacuum-assisted therapy) or silver-impregnated dressing was used to reduce wound exudation and provide a healthy wound bed before fat grafting. Autologous fat grafts were harvested from abdominal or gluteal regions of the patients and injected into the wound bed and wound environment. Clinical observation and photograph records were used to follow the wounds. Results: 12 wounds needed for covering with skin graft or flap surgery whereas 4 healed without surgery. After debridements, the mean wound surface area was 92.69±62.74 cm2 (125[52-175] cm2 for venous ulcers, 100[25-112] cm2 for diabetic ulcer, and 81[42-120] cm2 for traumatic ulcers). The mean fat injection time was 1.63±0.89, and the mean fat volume was 26.56±15.33 cc. The mean healing time was 32.56±12.03 days. The wounds were uneventful in the average 12 month-following periods. Conclusion: With the results of our study, it can be said that non-centrifuged autologous fat grafts can have beneficial effects on the treatment of chronic challenging wounds when it is present on the wound site during healing.