Indocyanine green angiography assisted amputation for acute management of frostbite of the lower extremity: A technique guide and case study

Frostbite is a common pathology seen in cold weather climates directly affecting peripheral tissues which at times can result in necrosis. While frostbite can be managed with rewarming, awaiting demarcation, and delayed surgical intervention. Indocyanine green angiography (IGA), makes use of a dye injection to evaluate the perfusion to an area of tissue. While the use of IGA has been used in the evaluation of major plastic surgery, vascular, and transplant procedures its use has not been studied in the usage of amputation planning to assess pedal perfusion. This is a proposed technique guide on the use of IGA in the planning of amputation secondary to frostbite injury. Results from this case show that the use of IGA was beneficial in establishing the proper amputation level to have the patient heal without major issue or have a need for additional procedures.