The treatment of local wounds is very important, as improper treatment can cause the ulcer or gangrene to spread and expand, resulting in prolonged treatment and even amputation and disability. Therefore, proper debridement and dressing changes are very important. In the absence of mastering the basic principles and timing of treatment of gangrene of the extremity caused by vascular disease, ignoring the peculiarities of ulcerative gangrene as a local manifestation of peripheral vascular disease, and taking general surgery, thorough debridement, bad toe amputation, bad leg amputation method is hardly effective, and the result is that the more treatment is heavier. Through years of clinical practice and experience, we believe that the treatment of vascular disease ulcers or gangrene must be based on the premise of systemic treatment such as controlling blood sugar, improving circulation and microcirculation, actively anti-infection, and controlling related acute and chronic complications, and according to the nature and severity of the ulcer and gangrene, seizing the time for treatment and carrying out localized Chinese medicine to remove the rot and trauma in stages is the key to the success or failure of treatment. Initial stage: superficial ulcers, lesions that have not yet reached muscle tissue, such as blisters, hemorrhagic blisters, 1-2 degree burns or frostbite and superficial skin injuries. Treatment focuses on blood sugar control and the use of effective antibiotics to prevent infection. For local wounds, change the medicine once a day to remove the ulcerated tissues, but should not overly clear the wounds, and give detoxifying and blood-vitalizing drugs, such as Erhuang San, Ru Yi Jinhuang San, muscle-generating cream or epidermal growth factor, etc. For blisters and hemorrhagic blisters, under strict disinfection conditions, the contents are extracted from the low part of the blister and coated with iodine to prevent infection to make it dry. Abscess formation stage: Infection of subcutaneous tissue forms cellulitis, abscess or sinus tract. At the same time of basic treatment, we should grasp the timing of incision and drainage of pus, and give Chinese medicine detoxifying lotion sand strips for wet dressing and drug change to keep the drainage unobstructed and avoid squeezing and excessive flushing to avoid spreading and expanding the infection along the muscle gap. The necrotic tissues are mostly removed gradually by nibbling. When the patient has undergone basic treatment, blood sugar and infection are effectively controlled, microcirculation is improved, and local inflammation is reduced, the scope and intensity of debridement can be increased, but attention is paid to protecting the tendons and ligaments that have the ability to live. Gangrene stage: For wet gangrene, gradually remove necrotic tissues while basic treatment, and give daily wet dressing changes with detoxifying and antiseptic herbs to keep drainage open. For dry gangrene or partial blackening of the toe, it can be removed from the base of the toe after the blood supply to the extremity is improved, local inflammation is reduced, and the demarcation between necrosis and normal tissue is clear. Myogenic stage: The timing of the myogenic and decay removal stages is relative and cannot be absolutely separated. Generally, in the late decay removal stage, necrotic tissue is gradually cleared, secretions are gradually reduced, the wound surface is relatively clean and red, and the focus should be on the application of myogenic drugs. You can use myogenic Yuhong cream, myogenic powder daily or every other day to change the medicine, in order to activate blood circulation, remove decay and produce muscle, improve microcirculation of the wound, and promote the growth and healing of granulation tissue.