Limb Necrosis - Necrosis Of The Leg, Foot And Toe

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Necrosis of the leg, foot and toe

Leg necrosis

Necrosis is a destructive process. It is characterized by swelling, loss of the form of the protein molecule (denaturation), thickening of cytoplasmic proteins, destruction of cellular organelles. As a result of such changes, the cell dies. By etiology, necrosis of the lower extremities is rheumatic, toxigenic, trophoneurotic and ischemic.

The main cause of tissue necrosis is a malnutrition of any of its areas due to trauma or damage by putrefactive inflammation, and most often this occurs with a combination of these factors. This pathology develops as a result of the impact on the cells of mechanical force (blows, ruptures, fractures), developing infection, high or low temperatures.

Usually necrosis of any part of the limbs is gangrene, it can be dry, wet and gas. Dry is considered more favorable. With wet gangrene, the general manifestations are much more pronounced. Necrotic phenomena can spread rapidly depending on the continuation of mechanical influence, the addition of infection and the anatomical and physiological characteristics of a person.

The beginning of the manifestation of the development of necrosis is characterized by severe pain, sensations of numbness appear, sensitivity is lost, motor functions are impaired. Pallor of the skin is noted, it becomes cold and takes on a marbled appearance, later the skin becomes bluish, and then begins to turn green or blacken. Patients complain of rapid fatigue of the legs, constant freezing, regardless of the season.

Convulsions may occur. The presence of non-healing ulcers is also a signal of the onset of gangrene. The death of tissue cells begins from the lower parts of the leg, gradually spreading, necrosis, reaches the part where the malnutrition occurred. On the border of dead and living tissues, a demarcation line is formed, which allows operatively removing the dead part of the leg along this line or above it.

This is the main tactic worked out by surgeons for years, it is the only correct method. Treatment of such patients is aimed at maintaining the general condition. It is necessary to restore the volume and composition of the extracellular and intracellular water space of the body. For this, blood, blood substitutes, antibiotics, vitamins, etc. are administered.

A special group of microbes can provoke gas gangrene. After infection, spores form in the wound, which quickly develop in the tissue with a violation of oxygen supply. This type of gangrene rapidly destroys muscle tissue. Microbes secrete substances that promote the breakdown of proteins and carbohydrates in necrotic tissues. A feature of this process is gas evolution. Gas gangrene is painful, the area of infection swells. Wounds ooze a foul-smelling fluid. The skin around the wound darkens, cracking when pressed. Gas gangrene cannot be cured without surgery. The entire affected area is removed or the limb is amputated.

Foot and toe necrosis

Foot necrosis can develop with an advanced stage of an ulcer or an uncontrolled infection in its place. Sudden blockage of a large artery, renal complications, diabetes mellitus also lead to necrosis. Neuropathic causes, i.e. disorders of the somatosensory nervous system, contribute to the appearance of necrotic processes.

Gangrene of the foot spreads from dead, infected areas. Sometimes ischemic gangrene is dry - it proceeds without infection. If the foot is affected by wet gangrene, it is necessary to take antibiotics and conduct microbiological studies on a regular basis. It is possible to achieve positive results from the treatment of foot necrosis only in the conditions of the department of surgery.

The treatment process is difficult, intensive measures are needed, with too widespread gangrene, the degree of danger can only be determined by the surgeon, often bypass surgery is the only way to save the foot. In some cases, tactics with the use of plastic techniques and long-term use of antibiotics make it possible to maintain to a certain extent the function of the foot and, most importantly, can prevent a person's disability.

When treating patients with severe limb injuries with purulent complications and necrosis of soft tissues and bones, autotransplantation is used - transplantation of the recipient's own stem cells. Treatment for finger necrosis is based on topical treatment that removes the necrosis within healthy tissue. The volume of the area to be removed depends on the type of necrosis.

With a severe stage, severe intoxication is observed, it is urgent to amputate the finger within the healthy tissues (above the level of the necrosis border). It should be borne in mind that more differentiated tissues are affected much faster, therefore, if the skin and muscles of the finger are affected, and the tendons and bone are not affected, only necrotic tissues are excised.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".