This paper introduces the clinical experience of Professor Cao Yemin in treating scleroderma gangrene （SG）， which he identifies as primarily affecting the "collaterals （luo）" and characterized by "deficiency， pathogens and stasis". The treatment can be divided into internal and external therapies. Internal therapy is tailored to the specific phase of the disease. In the acute phase， the primary focus is on "clearing"， using modified self-formulated Liangxue Heying Prescription to clear heat， cool the blood， harmonize the nutritive and blood levels， and resolve stasis. During the remission phase， the emphasis shifts to "nourishing"， where a combination of warming and clearing methods is used. The treatment prioritizes supporting vital qi， resolving stasis， cooling the blood， and unblocking the collaterals， with modified self-formulated Fuzheng Qingjie Prescription specifically designed for the treatment. External therapy is tailored to the specific stage of the disease， with an emphasis on the principles of elimination， support， and supplementation throughout the treatment process. Surgical intervention is advised to be delayed rather than performed prematurely， allowing for staged and progressive debridement and wound dressing techniques to establish a favourable wound microenvironment， protect the wound and surrounding tissues， and promote healing. Two proven cases are presented for illustration.