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.