Dry necrosis
The choice of methods for treating necrosis largely depends on their type. So, dry (coagulative) necrosis or dry gangrene usually does not progress, but is limited to any area of the body or organ. Dry necrosis is characterized by gradual drying of dead tissues, the formation of a demarcation line that clearly separates the dead tissue from viable tissue.
A decrease in the volume of necrotic tissue is also characteristic; this process is called mummification. The symptoms of the disease are characterized by the appearance of severe ischemic pain, the skin becomes pale, becomes marbled, and becomes cold. Pulse is disturbed, sensitivity disappears, a feeling of numbness appears. In the extremities, the pain is prolonged, there may be a spasm of collateral arterial branches.
Necrosis extends upward from the peripheral extremities to the level of vascular occlusion. Initially, action is required to prevent infection of the affected area. For this purpose, various fluids are introduced to prevent tissue infection. This necrosis poses a small threat to the patient's life, as it is limited to an insignificant amount of dead tissue.
It develops in people with more stable immunity, occurs in tissues rich in proteins and poor in fluids, proceeds without pathogenic microbes and is not a consequence of any concomitant diseases. The appearance of the disease is associated with impaired blood circulation in a certain area of tissue. Often dry necrosis as a result of insufficient blood circulation and lack of oxygen in the body, the action of various damaging factors affects the kidneys, myocardium, adrenal glands, spleen.
With atherosclerosis and arterial thrombosis, dry necrosis develops in the extremities, after burns and frostbite, affects the tissues of the fingers in Raynaud's disease, and the skin in typhus. The appearance of the disease is associated with impaired blood circulation in a certain area of tissue. Dry necrosis includes anemic infarctions, caseous necrosis in tuberculosis, glanders. With coagulation necrosis, dead cells lose their nucleus, but retain their shape for several days.
Under the microscope, cells without a nucleus are a jelly-like mass of homogeneous pink cytoplasm. The coagulation of cytoplasmic proteins makes them resistant to the action of lysosomal enzymes, so their liquefaction is slow. This type of necrosis is called dry because the dead areas are dense, dry, crumbly, white or yellow in color. Necrosis of tissue occurs with their dehydration.
- Coagulation necrosis is divided into several types:
- heart attack - vascular (ischemic) necrosis of internal organs. This most common type of necrosis does not develop in the brain tissue.
- caseous (cheesy) necrosis is a companion of tuberculosis, syphilis, lymphogranulomatosis.
- waxy, or Zenker's necrosis can develop with typhoid and typhus, cholera. This usually occurs in the muscles of the anterior abdominal wall and thigh.
- fibrinoid necrosis - occurs in the connective tissue in rheumatism, rheumatoid arthritis and lupus erythematosus, with malignant hypertension.
Stopping the further development of tissue cell death can be achieved not only with the help of surgical intervention. Local treatment of dry necrosis consists in treating the surrounding skin lesion with antiseptics. The use of dressings with ethyl alcohol, boric acid or chlorhexidine disinfects tissues, preventing the development of the microbial environment. In addition, necrosis zones can be treated with a traditional alcoholic solution of brilliant green.
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All procedures are prescribed by the attending physician, it is difficult to cope with such a disease on your own. Conservative therapy allows you to improve blood circulation in the affected organ. The blood supply is restored with the help of intimothrombectomy, bypass surgery. Treatment of patients with tissue necrosis is a rather difficult task and it often happens that it is impossible to solve it without surgery.
It is difficult to stop the process of cell and tissue death; drastic measures are required, which usually include the joint work of doctors of several specializations.
The success of treatment depends on the location of the pathology, the size of the necrotic area, and also on those changes that occur in the patient's body. When tissue necrosis occurs, it is necessary to direct the action to fight microbes using broad-spectrum antibiotics. Since the destroyed tissues have a toxic effect on the patient's body as a whole.
Each person has a choice to live healthy without tobacco, alcohol or suffer from diseases provoked by bad habits. Regular visits to the doctor will reveal the disease at an early stage of its formation.
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".
