The term necrosis, which comes from the Greek, describes the death of individual cells or cell groups in the living organism, which can result in the death of layers of tissue and ultimately also of limbs. In contrast, there is apoptosis, which is a physiological cell death.
What is necrosis?
The pathological death of individual cells, tissues or limbs is called necrosis. In humans, necrosis manifests itself depending on the type of tissue affected. Solid yellow foci of necrosis are found in the protein-rich tissues of the heart and spleen or gastrointestinal tract. See phonejust for Krukenberg Tumor Meaning.
In tissues poor in protein, necrosis triggers liquefaction. Gangrene may form as a secondary phenomenon. Two types of gangrene are distinguished here. Dry gangrene occurs when a necrosis dries up under the influence of air, turns black or blue-black and hardens.
Bacteria lead to the development of wet gangrene and trigger a foul odor and a damp, mushy change in consistency in the necrosis.
Necrosis is always based on inflammation, which ultimately leads to the death of the affected cells and tissues. This inflammation can be triggered by various environmental influences or a lack of nutrients or oxygen.
Circulatory disorders can also lead to necrosis. These factors can trigger individual cell death, which can eventually provoke an inflammatory response in the surrounding tissues. As a result, scavenger cells are attracted to the focus of inflammation, which release inflammatory messenger substances.
Apoptosis usually occurs as a co-phenomenon of necrosis. Secondary gangrene can also be triggered by bacteria. It occurs particularly frequently in extremities with poor blood circulation. In addition, this consequence of necrosis can also accompany arterial occlusive diseases.
Symptoms, Ailments & Signs
The main symptom of necrosis is cell death. The necrosis can be small or large. It can be superficial and affect the skin, or mean cell death in the internal organs. Necrosis on and in the skin is also quickly visible. The necrosis appears as black and yellow discoloration. Inflammation occurs before or after cell death occurs.
Accordingly, the spots can also redden, swell, hurt or lead to a feeling of warmth. The inflammation usually remains around the dying part and can create a feeling of tension. Necrosis can also lead to restricted mobility when it occurs in bones and joints.
Bacteria and other organisms can liquefy the dead tissue, leading to the discharge of pus and wound fluids. Sensitivity is often reduced at the dying areas. The dissolved tissue parts and the bacteria involve the whole body.
Those affected experience chills, a high fever, nausea and a strong feeling of illness. These symptoms occur more quickly, especially when internal organs are affected by the necrosis. In addition, affected organs can also show various signs of failure as a symptom.
Diagnosis & History
The diagnosis of necrosis is based on a comprehensive medical history. Furthermore, the physiological examination and assessment of the affected tissues, including checking the pulse and blood circulation, are carried out.
Imaging methods support the diagnostic process. Depending on the type and progress of the necrosis, it can be identified by the nature of the focus of necrosis, which varies depending on the tissue involved. The healing of the necrosis also depends on the type of tissue. Protein-rich intestinal cells, for example, can regenerate so that the necrosis is overcome by cell regrowth.
Further examinations and tissue analyzes clarify the exact type of necrosis. A distinction is made here between coagulation necrosis, adipose tissue necrosis, carapace necrosis, phosphorus necrosis, as well as caseation and tumorous necrosis.
Necrosis can have very different complications and symptoms. However, these depend heavily on the cause and the affected region in the body, so that a general prediction is usually not possible. However, necrosis also leads to disturbances in blood flow, so that internal organs can possibly be damaged by this disease. The quality of life of the patient is significantly reduced due to the illness.
Scars can also form due to the necrosis and thus have a negative impact on the aesthetics of those affected. As a rule, necrosis can be treated relatively easily. In most cases, there are no particular complications. In many cases, the body’s own reaction to this disease leads to self-healing.
Furthermore, the affected person is dependent on a healthy lifestyle and a healthy diet in order to prevent the symptoms of necrosis. With successful treatment, there is no reduction in quality of life. Necrosis can also be prevented if appropriate medication is taken after radiation therapy. Usually there are no complications.
When should you go to the doctor?
If signs of necrosis are detected, it is important to consult a doctor. People who notice unusual skin discoloration, mostly black and yellow, are best advised to consult their doctor. At the latest when the affected areas swell or cause pain, a doctor must determine the cause and, depending on the findings, initiate treatment.
People suffering from circulatory disorders or a bacterial infection are particularly susceptible to the development of necrosis. People who are exposed to harmful environmental influences over a longer period of time or who suffer from an eating disorder are also among the risk groups and should seek medical advice immediately if they have the symptoms described.
The treatment is carried out by the general practitioner or a dermatologist. Depending on the cause, other internists and alternative specialists such as naturopaths or physiotherapists can be consulted. Affected children should be brought to the pediatrician if they notice any strange skin changes and other symptoms that indicate a serious condition. In severe cases, the necrosis must be treated surgically.
Treatment & Therapy
The treatment of necrosis takes into account its natural healing process, which can be divided into the inflammatory and infection phase, resorption, regeneration and scarring.
Accordingly, the bacterial infection should be combated, for example, by administering antibiotics, regeneration and thus wound healing should be stimulated and scarring reduced. The primary goal of treatment is to restore the necrotic tissue to the status of a fresh wound and to prevent the inflammation from spreading.
In addition to surgery, lysis or the use of catheters can achieve this wound status. Already dead tissue, on the other hand, is removed so that the necrosis does not spread. In addition, when treating necrosis, care must be taken to continuously improve blood circulation in the affected tissue and to stimulate new tissue formation. Various factors for tissue perfusion must be taken into account here, including the positioning of the patient and the affected limbs, a constantly warm body temperature, and muscle work and muscle training.
As an alternative to tissue regeneration, however, necrotic tissue can also be replaced by scarring of another type of tissue. In addition to endogenous reactions that can lead to healing, necrosis can be treated pharmacologically.
Outlook & Forecast
The prognosis for necrosis can vary greatly. This depends on the location, the size and any germs. Overall, necrosis contaminated with bacteria or other germs will always become larger and more serious if left untreated. Necrosis that has been cleaned and is not accessible to pathogens, on the other hand, can be partially healed well by the body itself. However, this is only rarely the case and then affects, for example, a superficial decubitus or shallow necrosis as a result of a burn.
Necrosis caused by pathogens or massive tissue damage tends to spread. There is also a risk of sepsis, particularly in the case of internal tissue decline. Important organs can also be affected. If left untreated, the condition of those affected usually deteriorates. Internal necrosis can quickly become life-threatening, even with treatment.
Treated necrosis, which includes removal of dead tissue, has variable prospects for healing. The patient’s size, location, and general health are factors that greatly affect wound healing. Elderly and bedridden people survive this condition less well than young, well-fed and active people. Necrosis can take weeks or months to heal.
Necrosis can be prevented by avoiding harmful environmental factors on the one hand and by improving physical conditions on the other. The environmental influences to be avoided include bacteria, toxins and other pollutants. Continuous malnutrition and abuse of alcohol and drugs can also lead to the occurrence of necrosis. Necrosis as a result of radiotherapy can be prevented by anti-inflammatory drugs.
After surgical treatment of the necrosis, the wound is checked daily for signs of inflammation. The dressing material is selected by the attending doctor and ordered by prescription. Further follow-up care of the patient can be carried out at home by qualified nursing staff. The affected area of skin must be kept free and, if possible, elevated.
Furthermore, the aftercare of the necrosis consists of follow-up controls, which observe and describe the wound healing. It may happen that other dressing materials are required to achieve a better healing result.
Monitoring the wound for signs of inflammation (reddening, heat, swelling) is particularly important in the aftercare of necrosis. If a wound infection is suspected, it is necessary to take a blood sample to check the laboratory parameters and, if necessary, to take medication.
A final check after the necrosis has completely healed is carried out by the doctor. The patient receives sufficient information from the doctor or a suitably trained nurse. He learns how he can avoid the development of necrosis in the future. Especially for bedridden people, it is important to keep the extremities free and to allow for appropriate skin care and the supply of sufficient fluids. Successful long-term follow-up of necrosis involves good skin care and good observation so that it can be avoided in the future.
You can do that yourself
Patients suffering from necrosis can support the healing process with a number of measures and various household and natural resources. Increased personal hygiene prevents the affected area from becoming inflamed. Perfumed shampoos and care products should not be used for the first few days. A good alternative are natural [[shampoo[[s made from coconut oil or arnica. Patients should discuss the use of any care products with their dermatologist.
If scars form during recovery, massage can help. In the case of permanent skin changes, talking to friends and relatives, but also to a therapist, can help to overcome the mental problems. If, despite all the measures, further symptoms appear or other areas of the body that have died are discovered, a doctor must be consulted. The mentioned preparations should only be used with the approval of the doctor. Rest and bed warmth also apply.
Swollen areas of skin can be cooled with cooling pads. Special creams from specialist shops help with itching and discomfort, as does a paste made from sage and olive oil. This is applied to the affected area and inhibits the inflammatory processes.