The authors report on a single case of a large, civilian burn cared for at a U.S. military hospital during Operation Iraqi Freedom. The management of the patient, using a large negative pressure wound therapy device and the Meek grafting technique, is reviewed. This is a case report. The patient survived his injury. In Iraq, most patients with this severity of injury succumb to the injury. By using two innovative techniques, the authors found that the patient was able to survive his injury and return to his home.