At the Southern Arizona Limb Salvage Alliance (SALSA), we are frequently saddled with the most complex patients (and wounds) I have worked with in my career. Our "Toe and Flow" philosophy has been evolving to develop what we call “wound chemotherapy.”
Lately, we have been very active in modifying many of the techniques first described by Wim Fleischmann, MD, PhD, and others to provide active matrix management (negative pressure wound therapy) with other chemotherapeutic tools (i.e. antimicrobials/antiseptics, analgesics, etc.) to manipulate the wound environment.