Necrosis is the death of tissue in the body. It’s caused by factors like insufficient oxygen, infection and trauma. Symptoms include pain, swelling and notable skin issues. Treatment typically includes surgery, along with medications and oxygen therapy.
A clot can block small blood vessels, cutting off the blood supply to the area. This causes the tissue to die from lack of blood.
Pain
The most obvious sign of necrosis is pain in the affected area. The pain usually increases as the condition worsens. The pain might center around a bone or joint, such as in the groin, thigh or buttock with avascular necrosis of the hip; it might also occur in other joints, such as the shoulder, knee and foot. The pain might be more severe when you put pressure on the joint, or it might be present even when you are at rest.
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In addition to causing the pain, necrosis can cause other symptoms, including fever, rapid heart rate, mental deterioration from confusion to unconsciousness (septic shock) and blood pressure that falls due to a build-up of gas in the tissue. It can also produce black or greenish dead tissues called gangrene, which might look like the skin of a corpse.
Necrosis is not reversible, but treatment may slow the spread of the disease and prevent it from spreading to healthy tissue. The body will remove the necrotic tissue if the condition is caught early enough.
The condition can be caused by trauma, surgery or other injuries that interrupt the blood flow to a bone. It can happen in bones throughout the body, but it is most common in the ends of long bones. It can be a chronic problem, but it is most often seen in the hip, and it’s sometimes called Legg-Calve-Perthes disease in children. It can also be caused by conditions such as diabetes, alcoholism, cancer or certain metabolic disorders, such as Gaucher disease and lupus. Other causes include chronic renal failure and some medications, such as corticosteroids. Also, some types of infections can lead to necrosis, such as polymicrobial necrotizing fasciitis and monomicrobial necrotizing fasciitis, which are mainly caused by Clostridia or Staphylococcus aureus, respectively.
Swelling
As necrotic tissue dies, it releases chemicals that cause swelling in the area. This may be a sign of serious infection and requires immediate medical attention.
In addition to a physical examination, your doctor might take a sample of dead skin tissue for laboratory testing to confirm the diagnosis. A tetanus shot might be necessary as well, to protect against complications.
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The body’s cells are designed to die through a process called apoptosis, which happens naturally in healthy tissues to maintain cellular balance. Necrosis occurs when internal or external factors lead to irreversible cell injury and death. It’s often accompanied by pain, swelling and other symptoms.
Wounds, infections and burns all cause necrosis. Bedsores in immobile or bedridden patients are a common form of this condition, as is the dreaded gangrene, which gives the affected tissue a black, putrid appearance.
X-rays and a bone scan are the initial diagnostic tools used to identify avascular necrosis, although MRI is more sensitive than either of these methods. A common finding is a doughnut-shaped area in the center of the bone, known as the doughnut sign. This indicates that the blood supply to the bone has been cut off, a condition called ischemia.
Depending on the severity of the injury, surgical removal of the dead tissue, called debridement, might be necessary. This can range from removing small patches of tissue to amputating limbs in severe cases. Other treatments might include antibiotics, tetanus vaccine and oxygen therapy. If left untreated, the dead tissue can release bacteria that can infect healthy tissue, leading to more complications. Wound care nurses should follow a DIME approach (debridement, irrigation, moist dressings and evaluation/medication). The goal is to treat the underlying condition before it causes more damage.
Bleeding
Some types of necrotizing infection produce gas that causes the skin to look bubbled or to feel crackly when touched. The infection also causes the nerves to stop working, which makes you feel extremely ill and can lead to mental deterioration from confusion to unconsciousness (septic shock). In addition to pain, swelling, and fever, you may have other symptoms, such as bleeding in your digestive tract or blood vessels and breathing problems.
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Necrotic tissue is non-viable, and it will not become healthy again once blood flow returns to the area. A doctor can diagnose a necrotizing soft tissue infection from its appearance and symptoms, but may also order a blood or tissue sample for a laboratory test to determine what bacteria are causing the problem. Doctors usually begin treatment before the lab test results come back, so they can prevent the infection from spreading to other organs or body parts.
The type of necrosis you have determines what treatment options are available to you. For example, if you have wet gangrene from a bacterial infection, doctors will treat the infection with antibiotics and remove any dead tissue. They will also give you a tetanus shot to protect you from further infection.
The other kind of necrosis is dry gangrene from an underlying condition, such as diabetes or vascular disease. In this case, your doctor will treat the underlying condition to prevent more severe complications like amputation or death. They may recommend treatments such as negative pressure wound therapy, hyperbaric oxygen therapy, or surgery to improve blood flow to the affected tissue. They might also prescribe medicines, such as antibiotics or antifungal medications, to fight the infection.
Discoloration
The tissue affected by necrosis can take on a variety of different colors, ranging from pale or white to dark or black. The discoloration is due to the lack of blood flow and oxygen to the area. This also causes the skin over the tissue to become discolored. The tissue may appear dry and leathery or it can develop blisters, ulcers and a waxy appearance.
If the infection does not receive treatment, it can progress to a condition called gangrene. This is when large areas of body tissue begin to die, which is irreversible. To stop the spreading of gangrene, doctors must remove the dead tissue.
Necrosis is the death of cells in an area of the body, caused by a lack of blood flow to the tissues. The cell’s membrane ruptures, causing its contents to spill out into the surrounding tissues. The process is accelerated by certain diseases, infections and injuries.
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The symptoms of necrosis can vary depending on the type of tissue involved and what caused the injury. For example, a diabetic wound is more likely to develop necrosis than an uninfected wound that has been treated properly. Other factors that contribute to the development of necrosis include a blocked blood vessel, a stroke, a heart attack, obesity and some types of cancer.
When large areas of tissue are infected with bacteria, the infection can spread quickly through the skin and into underlying tissues. This is a severe medical emergency and requires immediate attention. The best treatment options for this condition include surgical debridement and antibiotics. If the infection is suspected to be TB, patients should also undergo a Mantoux skin test to see if they have latent TB infection or active TB disease.
