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/k g body weight). The method was first evaluated in the rat random cutan eous flap model and subsequently applied to determine skin perfusion i n a patient with peripheral arterial occlusive disease (PAOD), a patie nt with forefoot necrosis due to diabetic microangiopathy, and a healt hy volunteer. The observed kinetics of fluorescence appearance could o nly be explained by transition of the dye to a third compartment diffe rent from the blood plasma and having a greater affinity for indocyani ne 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 cl inical applications for the technique in dermatology and vascular and reconstructive surgery are briefly discussed. (C) 1994 Academic Press, Inc.