Doctors often have to deal with a problem such as necrosis. The types, causes and treatment of this disease can be safely attributed to the category of information relevant to modern society. Indeed, with the symptoms of necrosis of tissues and cells, a lot of ordinary people are faced. And sometimes the result of such a process can be fatal. Therefore, to study this issue makes sense.
What is necrosis?
This term implies the necrosis 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.
In fact, all types of necrosis appear due to the influence of an extremely strong irritant. Sometimes a mild irritant leads to a similar state. In this case, the exposure must be continuous in order to cause serious damage. An example of slow development is the conversion 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.
Autolysis should be understood as 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 it possible to fully heal after necrosis.
Exposure to various factors
Studying this topic, it will 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 tears, squeezing, crushing.
- Circulatory. We are talking about the cessation of blood supply in a certain area of the body due to obliteration of the vessel or prolonged spasm. The vessel may also be too tightly compressed by a tourniquet or blocked by a blood clot. The effect of the tumor cannot be ruled out.
- Electric. In contact with current, the body can be affected by a critical temperature, causing cell death.
- Toxic. Certain types of necrosis can result from the breakdown of microorganisms or the effects of their waste products.
- Neurogenic. Due to damage to the nerve trunks of the spinal cord, trophic ulcers are formed.
- Chemicals. This group of factors includes exposure to alkalis and acids. The former dissolve proteins and thereby cause wet collision necrosis. The second cause protein coagulation and lead to the development of dry coagulation necrosis.
As you can see, a variety of factors can affect the state of cells.
Varieties of necrosis
The death of tissues and cells can manifest itself in different ways. Moreover, the differences are sometimes significant. Here are the most common types of necrosis:
- Gangrene. This is a necrosis of tissues that come in contact with the external environment. It can be dry (coagulation necrosis) or wet (collicative tissue destruction). There is also a gas form caused by exposure to spore-forming microorganisms.
- Sequestration. This is a necrotic area, which is located in the sequestral cavity, separated from healthy tissues and filled with pus.
- Heart attack. Studying necrosis, definition, types and features of this disease, this form must be paid attention to without fail. This is a plot 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.
- Wet, it is colliquational. In this condition, unable to function tissues are melted by putrefactive microorganisms.
- Dry necrosis (coagulation). 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 hydrolytic decomposition and most often occurs under aseptic conditions.
Direct and indirect forms of necrosis
Considering necrosis, causes, signs, types and examples of this disease, it is worth paying attention to two manifestations of this problem, the main difference of which is reduced to the mechanism of occurrence.
The first of these is direct necrosis. For this process, cell death is characteristic directly in the place where the damaging agent acts. This can be a mechanical or chemical injury, the influence of radiation energy, bacteria, as well as the toxins that 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 death of tissues and cells 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 effects of apoptosis
This is a special form of manifestation of the destruction of cells and tissues. She must 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 development pattern. The bottom line is that cell death in this case occurs due to the activation of special genes in the nucleus. In fact, her suicide occurs. Here we are no longer talking about external influences, destruction is programmed by the body 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 of the extracellular environment. A similar 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 classical form, everything happens the other way around: the cytoplasm is the first stage of damage, and the nucleus is the last.
Another difference boils down to the fact that with apoptosis individual cells die throughout the body, while normal necrosis involves a large focus of destruction.
Diagnostics
Information about a problem such as necrosis (stages, types, outcome) will not bring tangible benefits if necrosis of cells or tissues is not detected on time. Therefore, the fate of the patient largely depends on professional diagnosis.
If there is reason to suspect necrosis of the internal organs, then the following types of examination should be performed:
- radiography;
- MRI;
- radioisotope scanning;
- CT scan.
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 record dangerous changes in the structure of tissues and accurately determine the form of the disease, as well as its stage.
Exodus
A problem such as tissue necrosis can have several logical endings.
The first is the resorption of necrotic tissue, after which its full recovery occurs. An example is the healing of small areas of necrosis in the liver or on the skin.
Examining necrosis, stages, types, outcome and the consequences of this disease as a whole, you need to pay attention to the fact that sometimes the process of cell death ends with resorption with the formation of a scar. This can be a scar on the skin after exposure to thermal or chemical factors, as well as a trace on the heart tissue, especially when myocardial infarction was transferred.
In some cases, the resorption process may result in the formation of a cyst. This often occurs in the brain after an ischemic stroke, which had the form of a heart attack.
Another possible outcome of necrosis is rejection by type of mutation or desquamation. In the first case, this refers to the process of rejection of organs or their parts. An example is the loss of toes in gangrene. The intestinal epithelium or epidermal cells that have died can be peeled.
Encapsulation and general death
Encapsulation of this process can be determined as the next outcome of necrosis. This state of tissue is observed when it is impossible to resorb or reject. A similar outcome is possible with tuberculosis.
The last and most severe 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 by etiological factor exposure - from chemical damage to heart attack.
The death of an entire organism can include two stages: clinical and biological. In the first case, the process can be reversible, in the second there is no chance of a positive outcome - breathing disappears, cardiac activity disappears and blood movement stops.
The cause of clinical death can be massive blood loss, shock, and agony.
Treatment
If necrotic changes in the tissues were diagnosed, then it is mandatory to hospitalize 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, be it an organ or tissue. If necessary, detoxification therapy or the administration of antibiotics can be carried out.
In some cases, the only relevant measure is surgical intervention, which reduces to excising dead tissue or limb amputation.
But depending on the form of the disease, treatment can have significant differences. In particular, the most common type of necrosis is vascular, it requires a special approach, since it is actually a heart attack.
Surgical intervention
In the case of diagnosing extensive necrosis of the chest and extremities, which significantly disrupt cell nutrition, lymph and blood circulation, as well as innervation, necrotomy is performed. This is the dissection of tissues that died as a result of frostbite, burns and for other reasons. With it, you can quickly transfer wet gangrene to 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.
With dry gangrene, the operation is sometimes delayed until the necrotic tissue is completely delimited. In parallel with this, it is necessary to conduct competent prevention of the development of wet gangrene.
In order not to encounter such a dangerous diagnosis as necrosis, you should initially take care of preventing the influence of those factors that can damage tissues and cells, thereby triggering the process of their necrosis.
Summary
Having examined the types of necrosis depending on the causes and other factors, we can conclude that this disease is extremely dangerous and needs high-quality quick diagnosis. Without professional treatment, the situation will be difficult to change. Therefore, the best thing you can do with the first symptoms indicating necrosis is to immediately visit your doctor.