Dr. Christopher Michael Brusalis, 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.

Tendon transfer surgery can be performed on the arms, hands, feet, or other areas of the body where a muscle becomes unable to pull on its tendon. A nearby tendon is detached from its bone, but kept connected to its muscle, nerves, and blood supply. The loose end is connected to the bone that the patient could not move. After the attachment heals, the patient will be able to move that part of the body by flexing the newly connected muscle.

One of the benefits to tendon transfer surgery is that it does not have to be performed right away after an injury. It can be successful even if the affected area has been paralyzed for years. It does take time to retrain the brain to use a different muscle for movement, but the surgery is a powerful option to restore needed motion.