Clinical Problem: A 41 year old newly diagnosed diabetic morbid obese male presented with a 7 day history of intense scrotal pain. Physical examine reveals an edematous, erythemic area with two purulent draining puncture wounds. CT scan showed diffuse fluid with subcutaneous air. Advancing tissue necrosis required radical debridement of the periscrotal area & left groin, down to, but not including the testicles. Cultures confirmed the diagnosis of Fournier's gangrene, necrotizing fasciitis of the perineum. Past Management: Before admission, the patient had undergone 2 previous I&D's at another hospital. An attempt was made to manage the exudate and treat the wounds with nugauze packing & po antibiotics. Current Clinical approach: Upon admission, IV antibiotics was started prior to surgery. After debridement, NS moisten gauze was applied for 24 hours for hemostasis. On post-op day #1 negative pressure wound therapy (NPWT) was initated, and the patient was taken to hyperbarics. Though premedicated, due to severe confinement anxiety, the treatment was cancelled. On post-op day #4 topical oxygen was utilized as an adjunct to NPWT dressing change. Patient Outcome: objectively,the scrotal tissue exhibited neovascularization & tissue regeneration.The wound decreased in size. After the first application of topical oxygen the tissue gap on the left groin region contracted and closed. On post-op day #6 granulated tissue covered the testicles. Subjectively, it was expressed that the airflow during the Topical Oxygen treatment felt soothing,and relieved pain. Thirteen days after admission,infection free, he was discharged to an Extended Care Facility. Conclusion: The 13 day hospital trial of NPWT & Topical Oxygen had positive outcomes for this patient. His positive results suggest that an indepth research on NPWT & Topical Oxygen could potentially be benefical for patients unable to tolerate the confinement of a hyperbaric chamber.