Infrared videoangiofluorography of the skin with indocyanine green--rat random cutaneous flap model and results in man.

We report a new technique for visualizing and measuring skin perfusion on a macroscopic scale using low doses of indocyanine green (0.3 mg/kg body weight). The method was first evaluated in the rat random cutaneous flap model and subsequently applied to determine skin perfusion in a patient with peripheral arterial occlusive disease (PAOD), a patient with forefoot necrosis due to diabetic microangiopathy, and a healthy volunteer. The observed kinetics of fluorescence appearance could only be explained by transition of the dye to a third compartment different from the blood plasma and having a greater affinity for indocyanine green. In PAOD reduced skin perfusion in the tissue surrounding the arterial ulcer could be clearly demonstrated, whereas skin perfusion in diabetic microangiopathy seems to be unaffected. Other potential clinical applications for the technique in dermatology and vascular and reconstructive surgery are briefly discussed.