Dr. Agustin Esquerra, MD

Debridement can be performed either surgically or nonsurgically; some methods are less invasive than others. Doctors select the appropriate debridement technique by considering the location, cause, and size of a patient's wound and may also weigh the patient's overall wellbeing, age, and risk of infection.

Surgical debridement is performed by cutting away dead, infected, and hyperkeratotic skin with a surgical scalpel. For deep wounds that tear away the skin and go into the muscle, skin from another region of a patient's body may be grafted onto the wound, which may then be periodically assessed and rebandaged until fully healed.

Non-surgical debridement is achieved with water or a dissolvent gel. Water softens the damaged skin and affected tissue, allowing doctors to remove it with wet-to-dry dressing. When wet tissue dries, it adheres to the dry dressing or bandage and comes off when the dressing is pulled away. In contrast, dissolvent gel deconstructs tissue, which can be cleaned off of the wound. Nonsurgical debridement is less invasive than surgical techniques; however, it can entail repeat treatments, slowing wound recovery.

While the prospect of stripping away skin may seem jarring, debridement can be critical to the treatment and healing of wounds which cannot not heal independently.

Professional cosmetic skin treatments exist to treat wrinkles, scars, dark spots, remove excess hair, tone and tighten skin, and otherwise improve the appearance of the skin. They may use lasers, light therapy, chemical peels, microdermabrasion, or many other forms of skin treatment.

Acne occurs when hair follicles become clogged with oil and dead skin cells, most commonly on the face or back. The clogged follicles can then become infected and inflamed. Treatments include antibiotics, anti-inflammatories, and retinoid creams.

Eczema is dry, sensitive skin that causes an itchy red rash, often in response to specific triggers. It is common in childhood but can sometimes last into adulthood. The main treatment involves keeping skin well moisturized.

Dermatitis is the medical name for any kind of skin inflammation or rash. Rashes can happen because of an allergy or contact with an irritating substance. They may be red, itchy, or even painful. They are often treated with antihistamines or moisturizing creams containing cortisone.

Psoriasis is patches of thick, red skin that is covered in silvery scales. It is often itchy and sore. Psoriasis is thought to be caused by an immune disorder, and it runs in families. Psoriasis is not contagious. There is no cure, but there are medicated creams available to treat the symptoms.

Skin growths, including warts and moles, are usually not serious. However, some skin growths should be examined by a doctor to make sure they don't cause problems in the future. Warts are harmless, rough, bumpy growths caused by a viral infection. They occur most often on the hands and feet. Because they are caused by a virus, they are contagious. Moles are brown or black spots that are sometimes raised slightly from the surface of the skin. They happen when clumps of pigment cells form in a cluster instead of spread out. Moles are harmless except that they are more vulnerable to cancer than other parts of the skin. Skin cancer is the most common form of cancer in the United States, and its risk increases with sun exposure and fair skin tone.

Skin issues can be embarrassing or irritating, but most are minor and can be treated without serious problems. Some, however, can be a sign of a more significant issue, so it is important to see a doctor for anything out of the ordinary.

Spinal cord injury medicine seeks to stabilize the spine and to alleviate the symptoms of spine damage. Practitioners of spinal cord injury medicine are called spinal cord injury specialists. Spinal cord injury medicine is an interdisciplinary field, meaning physicians of various specialties may be trained to treat spinal cord injuries.

Damage to the spinal cord may initially be diagnosed through X-ray, MRI, or CT scans. Patients can also undergo spinal exams to evaluate their sensory ability and strength. Injuries to the spinal cord can be complete (no feeling or sensation) or incomplete (some feeling or sensation remains). Conditions spinal cord injury medicine specialists may treat include:

• Paralysis, such as paraplegia (loss of function in the legs), or quadriplegia (loss of function from the neck down)
• Spine fracture or trauma, which can lead to impairment and/or significant pain
• Spinal infections
• Myelopathies, such as herniated disks, spinal tumors, and rheumatoid arthritis
• Inflammatory diseases such as ankylosing spondylosis, and degenerative conditions like Lou Gehrig's disease (ALS)

Treatment for spinal cord injuries often involves surgery, either directly after an injury occurs or at a later date. Surgery for spine injuries is intended to ease spinal compression and stabilize the spine. Surgical procedures can involve shifting vertebrae, removing bone, or altering spinal placement with implantable devices. Patients with significant spinal trauma may require urgent surgical intervention.

Surgical treatments can be complemented by rehabilitative physical therapy to improve mobility. Spinal cord injury specialists also treat complications arising from a spinal injury, such as respiratory or bladder conditions. Some patients with spinal cord injuries may require lifelong treatment. Spinal cord injury specialists aim to help these patients successfully adjust and lead an improved quality of life. An emerging treatment for spinal cord injuries is neural prosthetics, which replicate patients' lost nerve function. Neural prostheses may be used as artificial body parts or assistive devices that patients may cognitively control. Other assistive devices include wheelchairs and scooters.

Spinal cord injury specialists may collaborate with physical therapists, radiologists, neurologists, urologists, and orthopedists.