Inclusion Criteria:  type-1 and type-2 diabetes mellitus age >18-years both sexes chronic diabetic distal ulcers/gangrene (digital or forefoot) intended as W-grade 1 to 3 according to WifI classification; absence of active vascular issues or patients undergoing lower extremity revascularization to improve peripheral perfusion intended as I-grade 0 to 2 according to WIfi classification; absence of infection signs or presence of soft tissue infection intended as fI-grade 0 to 2 according to Wifi classification, without radiologic signs of bone infection (negative X-ray for osteolytic lesions);  Exclusion Criteria:  extensive ulcers with deep involving proximal forefoot and/or deep, full-thickness heel ulcer, with calcaneal involvement (W-grade 3 according to WifI classification); active vascular issues [I-grade 3 according to Wifi classification]; ulcers with signs of moderate and/or severe infection (osteomyelitis and/or sepsis) [fI-grade 3 according to WifI classification]; severe comorbidities such as severe heart failure, liver failure, and/or psychiatric disorder; previous oncological treatments (past 5 years) or ongoing and/or neoplastic lesions; corticosteroid therapy; coagulopathy; infection of the harvesting site; local anesthetic allergy; immunosuppressive therapy.