Introduction. Advances in molecular diagnostic medicine have allowed for more rapid, accurate, and comprehensive methods for identifying microorganisms in a chronic wound, which led to the development and use of a tailored topical antibiotic gel aimed at treating this bioburden. Objective. This is a retrospective chart review evaluating the authors’ early experience with the use of bacteria-specific antimicrobial gel therapy on chronic lower extremity wounds that have not responded to standard therapy. Materials and Methods. All patients in the study were treated with a topical gel along with standard of care modalities. Results. A total of 48 patients with 76 wounds (50/76 venous leg ulcers; 65.8%) were identified and analyzed. Of the 48 patients, 11 (22.9%) had complete wound closure at a mean of 101.6 days of treatment. The number of wounds decreasing in size improved from 45.3% to 77.6% after gel therapy. An analysis of all wounds showed an increase in size by 0.7% weekly with the topical gel; however, a mean weekly healing rate of 6.5% was seen when analyzing only the subset of wounds that decreased in size. Conclusions. Although a minor improvement of weekly healing rate was seen for a subset of the wounds, the overall wound closure rate was low.