Wound piercing: a novel approach for deep cutaneous ulcer cleansing.

AIM To achieve healing of cutaneous deep and complicated ulcers, along with adequate ulcer debridement and microbespecific antibiotics, any fluid and/or exudate stasis should be avoided. METHODS We have designed a surgical procedure of ulcer piercing and drainage with silastic tube which allows a continuous or daily cleansing of any pierced hidden tract by positive pressure irrigation. This procedure has been utilize in a series of 11 patients with deep infected recess of a sacral pressure ulcer (n=5), of 2 posttraumatic leg ulcers (n=2), of a deep perianal fistula (n=1) and dehiscence of a laparatomic surgical wound (n=3). RESULTS In these patients deep ulcer recess completely recovered within 2, 3.5, 1.5 and 2.5 months with ulcer piercing procedure. CONCLUSION Therefore, taking into consideration the advantages and the lack of advers, side effects or contraindications, the ulcer piercing procedure represents a small but effective step toward a better, safer and conservative approach in the treatment of deep complicated cutaneous ulcers.