Clinical Problem: 53 year old male residing in a community hospital required transfer to an 850-bed Magnet hospital due to respiratory distress. A secondary diagnosis of lower extremity cellulitis with maggot infestation and infection was transferred with him. Past Management: Past medical history significant for schizophrenia, diabetes, heart failure, obesity, and venous insufficiency. The patient was estranged from family, living alone, and non-compliant with medical treatments. Initial exam revealed an unkempt patient with poor hygiene and bilateral lower extremities with edema, hemosiderin staining, crusted dry exudates, suspicious odor, and maggot infestation. Collaborative Approach: Wound care nurses were presented with the challenge to treat the infection every six-hour with Acetic Acid solution 0.25%, to increase wound base acidity, leading to the question: How to apply Acetic Acid solution to bilateral extremities every six-hours? Burn Center nurses were consulted on how to treat such a large area, so frequently and the following treatment was developed: Each leg was wrapped with laparotomoy sponges soaked in Acetic Acid solution; four red rubber catheters with small holes cut along the length were placed on top; cling wrap soaked in Acetic Acid solution was next; and the entire dressing was wrapped with self-adhering pressure bandage to hold it in place. Every six-hour the red rubber catheters were flushed with 30cc of Acetic Acid solution and the entire dressing was changed every 24 hours. Patient Outcomes: After 72-hours the bilateral lower extremities were no longer edematous and the bio-burden was reduced. The dressings were discontinued and the legs were closely monitored and moisturized. Conclusion: Through collaboration with the Burn Center, the presenting organization wound care nurses were able to effectively treat the infection without the use of systemic antibiotics.