Chronic and acute wounds with long tunneling or undermining are always a challenge to wound care providers. One of the most frequently employed treatments for closing tunneled or undermined wounds is negative pressure wound therapy (NPWT). The benefits of this treatment system are widely discussed in the professional literature, and will not be covered here. Even though NPWT allows for faster wound healing initially, in some cases, progress to wound closure is limited and healing stops after reaching a maximum potential, which may occur after just a few weeks. This adverse phenomenon is more common when the wound exhibits deep tunneling or has been extensively undermined. Trying variations of NPWT strategies geared toward closing these wounds is usually unsuccessful. This article describes cases where combined therapy, using the V.A.C.® Therapy System (KCI, San Antonio, Tex) and the autologous platelet-derived gel, AutoloGel™, (Cytomedix, Rockville, Md) was employed.