Thermographic localization of incompetent perforating veins in the leg

Incompetent perforating veins in the leg were localized separately by clinical and thermographic methods. Clinically, the methods used were a multiple tourniquet test and palpation for fascial defects. Thermographically, the diagnosis of an incompetent perforator was made by finding rapid and localized heat flow to the skin in a cooled limb with occlusion of circulation in the superficial veins distally and proximally. Exploration of all the sites marked clinically or thermographically showed that the clinical method detected 60%, missed 40%, and gave false-positive results in 40%, while thermography detected 94.5%, missed 5.5%, and contributed 13% false-positive results. All these findings show a highly significant difference (P<0.0005) in favour of the thermographic technique as against the clinical method.