Coagulative necrosis: description, causes and treatment

Necrosis represents irreversible process of destruction and death of cells, organs, which is caused by exposure to pathogenic bacteria. The reason for the development could be: high temperatures (burns), chemical, or infectious agents, mechanical damage. Necrosis may be coagulative (dry) or collocational (wet). The article will discuss in more detail the reasons of occurrence of dry necrosis, and the methods of its treatment.

What is coagulation necrosis

Dry necrosis often affects organs rich in protein but low in liquid content. These include:

• Kidneys;
• Adrenal
• The spleen;
• Myocardium.

The Death of the cells of the organs occurs due to insufficient blood supply and oxygen enrichment as a result of thermal, chemical, mechanical and toxic damage. As a result, dead cells dry, and the process of mummification. Dead cells are differentiated from live clear line.

Causes of dry necrosis

Dry necrosis occurs if:

• It was a process of violation of blood supply to a specific area of a particular organ, in the end, there is a shortage of oxygen and essential nutrients;
• The disease developed gradually;
• Diseased organs did not have sufficient amounts of fluid (body fat, muscle);
• In the affected area of the cells was absent in pathogenic microbes.

The Development of dry necrosis is more prone to people with strong immune systems and malnutrition.

Coagulation necrosis: mechanism development

Due to insufficient oxygenation of cells and circulatory disorders is the process of coagulation and compaction of the protoplasm, then the affected area dry. Damaged parts have a toxic effect on the neighbouring living tissues.

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The Affected area has a characteristic appearance: the dead cells are delineated by a clear line and have a pronounced yellow-gray or clay-yellow. This area over time, compacted. When you cut, you notice that the fabric is completely dry, have a cheesy consistency, this figure is fuzzy. As a result of decay of a nucleus appear as a homogeneous mass of cytoplasm. Further, the development of necrosis and inflammation, you may notice the exclusion of dead tissue. If the disease affects the ear or the bones of a man, formed a fistula. However, the mechanism of development of coagulative necrosis are still not clear.

Varieties of coagulation necrosis

Coagulative necrosis includes several types:

• Infarction – the most common type. Develops as a result of coronary heart disease. Does not develop in the tissues of the brain. Myocardial possible complete regeneration of damaged tissues.
• Waxy (cancerously) – develops as a result of serious infectious damage. The disease affects muscle tissue, usually the adductor muscles of the thigh and the anterior abdominal wall. The development of necrosis provoked transferred earlier diseases such as typhus or typhoid fever. The affected areas are gray in color.
• Caseous necrosis – specific type of disease. Satellite tuberculosis, syphilis, leprosy, leprosy, disease Wegener. In this type of necrosis is the death of the stroma and the parenchyma (fibers and cells). A feature of this disease is that, except for dry areas, formed a pasty or cheesy granulomas. Affected tissues have a bright pink color. Caseous necrosis is one of the most dangerous types due to the fact that it is able to kill huge areas.
• Fibrinogenic – a disease in which damaged connective tissue. Necrosis develops in autoimmune diseases such as in lupus or rheumatoid arthritis. The disease most severely affects the smooth muscles and fibers of the blood vessels. Fibrinoid necrosis is characterized by a change of the normal state of collagen fibers and accumulation of necrotic material. Microscopic examination of affected tissue like fibrin. While the dead have a bright pink color. Areas, affected fibrinoid necrosis contains large amounts of immunoglobulin, as well as breakdown products of fibrin and collagen.
• Fat & ndash; the disease is the result of contusions and hemorrhages, and also in destruction of the thyroid tissue. When necrosis affects the peritoneum, and mammary gland.
• Gangrenous – can be dry, moist, gas. Bedsores in bedridden patients also apply to this type of necrosis. Most often appearance of the disease contribute to the bacteria on the affected areas.

Dry gangrene as a form of coagulation necrosis

Dry gangrene-a disease in which develops skin necrosis in contact with the external environment. As a rule, in the development of the disease any microorganisms are not involved. Dry gangrene most often affects the limbs. Damaged tissues are dark, almost black color and a strongly defined outline. The colour changes under the influence of hydrogen sulfide. This happens because hemoglobinemia pigments are converted into iron sulfide. Dry gangrene develops under the following conditions:

• Thrombosis of arteries and atherosclerosislimbs.
• When exposed to limbs high or low temperatures (burns or frostbite).
• With the development of Raynaud's disease.
• The presence of infections, for example, when the typhus fever.

The Treatment is only by surgical removal of dead tissue.

Wet gangrene

Wet gangrene-a disease that develops when getting a bacterial infection on the damaged tissue. The disease affects organs rich in moisture, can occur on the skin, but often spreading to internal organs. Wet gangrene affects the intestines (obstruction of the arteries), and lungs (occurs as a consequences of pneumonia).

Often, the disease occurs in children as their immunity upon accession infection more susceptible to the formation of gangrene. The defeat exposed the soft tissue of the cheeks and perineum. The disease water called cancer. The affected areas become very swollen and have dark color. No delimiting contour, so the disease is difficult to surgical treatment, as it is difficult to determine where the end of the affected tissue. Gangrenous areas have a very unpleasant smell, the disease often leads to death.

Gas gangrene and bedsores

Gas gangrene in its manifestations very similar to wet, but the causes of different development. This type of gangrene develops in case if starting to the affected tissue necrosis get the bacteria species Clostridium perfringens and actively proliferate. Bacteria in the course of their life allocate specific gas that is detected in the affected tissues. The mortality in this disease is very high.

Bed Sores are one of the types of gangrene, in which the process of dying fabrics. Diseases most susceptible to bedridden patients, as certain areas of the body due to prolonged immobilization are under pressure and do not receive the necessary substances along with blood. The result is the death of skin cells. Defeat the most exposed region of the sacrum, heel, thigh.

Diagnosis of coagulation necrosis

Diagnosis “coagulative necrosis" in case of damage are superficial, the doctor enough to take the blood and damaged tissue sample for analysis.

If there is a suspicion of necrosis of organs, a survey carried out is more extensive. To do this:

• Hold x-rays. Particularly relevant for this study, if there is a suspicion of gas gangrene.
• Hold radioisotope study. Granted, if an x-ray revealed no changes (at the initial stage of the disease). The human body is injected a radioactive substance. If there is necrotic change in the tissues of the body, it will be highlighted in dark stain.
• A CT. Performed if there is suspicion of bone lesions.
• To Conduct an MRI. The most effective method of research, it reveals how even minor changes associated with impaired blood circulation.

Complications of necrosis

The Necrosis is “death” of damaged organs and tissues. Therefore, its various types, such as infarction, necrosis of the brain, kidney or liver, can lead to death.

Extensive necrosis can lead to serious complications, for example, when multiple pressure ulcers may join a dangerous infection. The dead tissue is isolated in the body the products of their decay, thus resulting in toxic complications. Even more mild forms of the disease can lead to unpleasant consequences, such as scarring in the myocardium or cyst in the brain.

Treatment of necrosis

The Treatment of necrosis begins with identifying the species, assessing damage caused to them and the identification of comorbidities.

When the diagnosis of "dry necrosis of the skin" is assigned to local treatment:

• Treatment of affected areas with green paint.
• Clean the surface of the skin with antiseptics.
• Applying the bandage solution "Chlorhexidine".

The Patient is assigned a medical and surgical treatment to restore normal blood circulation, including in the affected areas. To remove dead skin cells most commonly performed surgical operation to resection the affected areas. Limb amputation is done in order to protect healthy areas from the spread of the disease.

Dry necrosis of the internal organs is treated using anti-inflammatory drugs, vasodilator, chondroprotectors. In the case of treatment failure, surgical treatment.