Statement of Problem: Numerous advanced wound management products/modalities are available to enhance and advance wound healing, and the practice of combining wound care modalities is not new, but has not been adequately or rigorously studied.

Rationale: Combined wound care therapies were utilized to expedite granulation, contraction, and epithelialization in preparation for a delayed surgical closure.

Methodology: Initially, the wound required debridement to optimize a clean wound bed. Once the wound base had 25% or less necrosis, the wound care modalities utilized were papain-urea debriding ointment with chlorophyllin copper complex under NPWT.

Over a span of 8 weeks, the wound granulated and contracted. The wound measured 13.5 x 9.5 x 3cm at the onset of the combined treatment. By the end of 8 weeks, the wound measurements were 9 x 4 x 1.5cm. The reduction in wound length was over 67%, width reduction was 42% and the depth decreased by 50%.

At the end of 8 weeks, the wound produced an odor and cadexomer iodine products were used under NPWT to decrease the bacterial load to prevent regional wound and systemic infection. The wound base continued granulating, contracting and epithelializing until a delayed surgical closure was accomplished.

Results: Using a variety of wound care modalities provided a synergistic effect in granulating the wound base and preparing the patient for surgical closure.

Conclusion: Combining methods/therapies can provide better symptom control and a synergistic effect of promoting orderly wound healing by promoting faster granulation and wound contraction.