A mildly malnourished nine-year-old girl in Ghana, West Africa, suffered for several years from a large painful lower leg ulcer which extended into the muscle tissue. The family had been pouring tetracycline powder into the wound, so while it was not infected, the woundbed was dry and the wound size was increasing. The humidity during this time was always under 10% and often under 5%, so keeping the wound moist was a challenge. The patient's dressing needed to stay in contact with the deep woundbed as she did her many strenuous household chores. Use of standard foam and hydrocolloid dressings led to dramatic fungal and bacterial infections in this very warm (110º F daily) setting. Flexible polymeric membrane dressings have demonstrated ability to reduce wound pain and inhibit infection while keeping wounds appropriately moist. Therefore, polymeric membrane dressings were initiated. Treatment included prayer, a course of oral antibiotics and direct wound care. After thorough cleansing, polymeric membrane dressings were initiated and were changed four times per week. Pain subsided quickly. Epibole was treated by placing a large piece of thick polymeric membrane dressing over the wound and then using rolled-up gauze to push it into contact with the deep wound surface. This was secured with cotton cloth strips. Usually no wound-bed cleansing at all was needed. Granulation tissue formed quickly and the woundbed moisture remained appropriate without infection or maceration. The wound-bed remained free of infection and the ulcer, which had been a painful problem for the child for several years, was completely healed in 38 days. Polymeric membrane dressings provided effective wound management for this ulcer, which extended into the muscle tissue, from initiation of treatment to complete wound closure.