Doctors often have to deal with the problem of necrosis. The types, causes and treatment of this disease can be safely classified as relevant information for modern society. After all, quite a lot of ordinary people face the symptoms of necrosis of tissues and cells. And sometimes the result of such a process can be fatal. Therefore, it makes sense to study this issue.
What is necrosis
This term implies the death of cells in the human body with the final stop of their functions. That is, life activity in a certain part of the body after the completion of necrotic processes is no longer possible.
Virtually all types of necrosis appear due to the influence of an extremely strong stimulus. Sometimes a weak stimulus leads to a similar state. In this case, the exposure must be prolonged to cause serious damage. As an example of slow development, it is worth citing the transformation of reversible dystrophy into irreversible. This process is divided into several key stages. We are talking about paranecrosis, when the changes are still reversible, necrobiosis (the changes are irreversible, but the cells are still alive) and necrosis, in which autolysis occurs.
Under autolysis standsunderstand the fact of self-digestion of tissues and cells that died due to the action of certain enzymes. In fact, this process is very necessary for the body, since it makes possible full healing after necrosis.
The impact of various factors
Studying this topic, it would be logical to pay attention to the factors due to which various types of necrosis may appear. Their list is as follows:
- Thermal. Exposure to temperatures falling below -10°C or above +60°C.
- Mechanical. These are ruptures, squeezing, crushing.
- Circulatory. We are talking about the cessation of blood supply in a certain part of the body due to obliteration of the vessel or prolonged spasm. The vessel may also be too tightly squeezed by the tourniquet or blocked by a thrombus. Tumor exposure cannot be ruled out.
- Electrical. When in contact with current, the body can be affected by a critical temperature that causes cell death.
- Toxic. Certain types of necrosis may result from the breakdown of microorganisms or exposure to their waste products.
- Neurogenic. Due to damage to the nerve trunks of the spinal cord, trophic ulcers form.
- Chemical. This group of factors includes exposure to alkalis and acids. The former dissolve proteins and thereby cause wet colliquational necrosis. The latter are the cause of protein coagulation and lead to the development of dry coagulation necrosis.
As you can see, oncell he alth can be affected by a variety of factors.
Varieties of necrosis
The necrosis of tissues and cells can manifest itself in different ways. And the differences are sometimes significant. Here are the most common types of necrosis:
- Gangrene. This is necrosis of tissues that are in contact with the external environment. It can be dry (coagulative necrosis) or wet (colliquation tissue destruction). There is also a gaseous form due to the action of spore-forming microorganisms.
- Sequestration. This is a necrotic area that is located in a sequestral cavity, separated from he althy tissues and filled with pus.
- Heart attack. Studying necrosis, definition, types and features of this disease, attention must be paid to this form without fail. We are talking about a section of an organ or tissue that has undergone necrosis due to a sharp cessation of blood supply. In fact, we are talking about ischemia. It is for this reason that such necrosis is often called ischemic.
- Moist, aka colliquational. In this state, tissues unable to function are melted down by putrefactive microorganisms.
- Dry necrosis (coagulative). Its development is based on tissue dehydration and protein coagulation. The tissues themselves with this type of necrosis become dense, wrinkled, atrophic and dry. This form is difficult to hydrolytize and most often occurs under aseptic conditions.
Direct and indirect forms of necrosis
Reviewingnecrosis, causes, signs, types and examples of this disease, it is worth paying attention to two manifestations of this problem, the main difference of which comes down to the mechanism of occurrence.
The first one is direct necrosis. This process is characterized by cell death directly in the place where the damaging agent acts. This may be a mechanical or chemical injury, the influence of radiation energy, bacteria, as well as the toxins they produce. This also includes allergic necrosis and those injuries that are the result of the destructive effects of highly concentrated alkalis and acids.
Indirect necrosis looks a bit different. The main difference is the fact that the process of tissue and cell death can occur at a certain distance from the place where the damaging agent acts. It makes sense to include such types of necrosis as trophoneurotic and vascular.
It is worth noting that at an early age, a direct form of tissue damage is more common, which is mainly due to allergies and various microbial factors.
The impact of apoptosis
This is a special form of manifestation of the destruction of cells and tissues. She needs to pay attention if the goal is to figure out what necrosis is. Apoptosis, the types of destruction discussed above, leaves aside because of its unusual pattern of development. The bottom line is that cell death in this case occurs due to the activation of special genes in the nucleus. In fact, she is committing suicide. It doesn't go here anymorewe are talking about the impact from the outside, the destruction is programmed by the organism itself.
The reason for the inclusion of apoptotic genes is the activation of the cytoplasmic protein p53, which is able to adapt to a variety of factors in the extracellular environment. Such a process can be spontaneous with different mutational rearrangements of genes.
Apoptosis differs from ordinary necrosis in that the destructive process begins immediately in the cell nucleus, and only then the death of the cytoplasm is recorded. In the classic form, everything happens the other way around: the cytoplasm is the first stage of damage, and the nucleus is the last.
Another difference is that during apoptosis, individual cells die throughout the body, while normal necrosis involves a large focus of destruction.
Diagnosis
Information about such a problem as necrosis (stages, types, outcome) will not bring tangible benefits if the necrosis of cells or tissues is not detected in time. Therefore, the fate of the patient largely depends on professional diagnostics.
If there is reason to suspect necrosis of internal organs, then the following types of examination should be carried out:
- X-ray;
- MRI;
- radioisotope scan;
- computed tomography.
Thanks to these techniques, it becomes possible to accurately determine the size and location of the affected area. Such an examination also allows you to fix dangerous changes in the structure of tissues and accuratelydetermine the form of the disease, as well as its stage.
Exodus
A problem like tissue necrosis can have several logical outcomes.
The first is the resorption of necrotic tissue, after which it is completely restored. An example is the healing of small areas of necrosis in the liver or on the skin.
Considering necrosis, stages, types, outcome and consequences of this disease in general, it is necessary to pay attention to the fact that sometimes the process of cell death ends with resorption with the formation of a scar. It can be a scar on the skin after exposure to thermal or chemical factors, as well as a mark on the tissue of the heart, especially when a myocardial infarction has been suffered.
In some cases, the resorption process may end with the formation of a cyst. This often occurs in the brain after an ischemic stroke that has taken the form of a heart attack.
Another possible outcome of necrosis is rejection by the type of mutation or desquamation. In the first case, we mean the process of rejection of organs or their parts. An example is the loss of toes due to gangrene. The intestinal epithelium or epidermal cells that have died can be sloughed off.
Encapsulation and total death
Encapsulation of this process can be defined as the next outcome of necrosis. This state of tissues is observed when their resorption or rejection is impossible. A similar result is possible with tuberculosis.
The last and most severethe form that the outcome of this disease can have is total death. The reason for this completion of the process of necrosis may well be some kind of necrosis according to the etiological factor of influence - from chemical damage to a heart attack.
Death of the whole organism can include two stages: clinical and biological. In the first case, the process can be reversible, in the second there is no chance for a positive result - breathing disappears, cardiac activity disappears and blood flow stops.
Clinical death can be caused by massive blood loss, shock and agony.
Treatment
If necrotic changes in tissues were diagnosed, then it is imperative to be hospitalized in a hospital.
Most often, to achieve the desired result, drug therapy is used to restore blood flow in the affected area of the body, whether it be an organ or tissue. If necessary, detoxification therapy or the introduction of antibiotics can be carried out.
In some cases, the only actual measure is surgery, which is reduced to the excision of dead tissue or amputation of limbs.
But depending on the form of the disease, treatment can have significant differences. In particular, the most common type of necrosis - is vascular and requires a special approach since it is actually a heart attack.
Surgery
In case of diagnosing extensive chest necrosis andextremities that significantly disrupt cell nutrition, lymph and blood circulation, as well as innervation, necrotomy is performed. This is the dissection of tissues that died due to frostbite, burns and other reasons. With its help, you can quickly turn wet gangrene into dry.
Such excision and removal of dead tissue is carried out only after determining the boundaries of necrosis using a mechanical stimulus. This can be a touch with a metal ball, a surgical instrument, or a needle prick from a syringe.
In dry gangrene, surgery is sometimes delayed until the necrotic tissue is completely demarcated. In parallel with this, it is necessary to carry out competent prevention of the development of wet gangrene.
In order not to face such a dangerous diagnosis as necrosis, you should initially take care of preventing the effects of those factors that can damage tissues and cells, thereby starting the process of their necrosis.
Results
After considering the types of necrosis depending on the causes and other factors, we can conclude that this disease is extremely dangerous and needs high-quality rapid diagnosis. Without professional treatment, the situation will be difficult to change. Therefore, the best thing to do at the first symptoms indicating necrosis is to visit a doctor without delay.
