Changes in cutaneous circulation in response to local and whole body heat stresses have been reported to occur due to a combination of local and neurally mediated vasodilation of the cutaneous vascular system. These mechanisms are predominantly mediated by temperature changes and result in shunting of blood from the core to the periphery at upwards of 7-8L/min in cases of where profound heat stresses are applied. The ability of local heat stress applied to increase cutaneous circulation may be of benefit in the extremity affected by an acute or chronic wound in the presence of peripheral arterial disease. The Rooke® Boot is designed to protect the limb for additional trauma, insulate the limb to reduce the effects of heat loss and offload the limb to assist in wound healing. It was hypothesized that the effect of heat retention may also result in increased local skin perfusion. Six subjects with extremity wounds in various locations were studied prior to and following application of a Rooke® boot device for 60 minutes and some additional days or weeks after daily use. All six patients exhibited signs of increased warmth and local cutaneous perfusion as documented with fluorescence angiography. Fluorescence angiography was also able document shunting of this increase cutaneous blood flow to the area of the wound. This may result in healing of wound that might not heal due to the presence of peripheral arterial disease.