Table of ContentsView AllTable of ContentsTypesPatternsCausesRisk FactorsSymptomsTreatment
Table of ContentsView All
View All
Table of Contents
Types
Patterns
Causes
Risk Factors
Symptoms
Treatment
Necrosis is the death of tissues of the body. Necrotic tissue forms when tissue isn’t getting enough blood as a result of circumstances like injury, infection, or chemical exposure. The resulting damage cannot be reversed. The term “gangrene” refers to a large area of necrosis.
This article discusses the types of necrosis as well as the causes and risk factors. It also covers symptoms of necrotic tissue and how it’s treated.
Verywell / Cindy Chung
Types of Necrosis
There are several types of necrosis, as it can affect many areas of the body, including bone, skin, organs, and other tissues. Each type has distinct features.
The type of necrosis that develops depends on which tissues are necrotic and what event (such as an injury or infection) triggered it. The types include:
Coagulative Necrosis
Coagulative necrosis occurs when there is a lack of blood flow, cutting off the supply of oxygen to the affected tissues.One way this can happen is when an artery becomes blocked due to ablood clot.
Coagulative necrosis can affect any organ in the body except for the brain. The necrotic tissue becomes firm and pale in comparison to surrounding tissues.
Liquefactive Necrosis
Liquefactivenecrosis happens as a result of a bacterial, viral, fungal, or parasiticinfection. It can also occur in the brain due to an ischemic injury, such as astrokethat causes the death of brain tissue.
This type of necrosis is typically seen in the brain, the lungs, or the tissues surrounding a site of infection. Liquefactive necrotic tissue softens until it turns into apus-filled abscess.
Caseous Necrosis
Caseousnecrosis is another type of necrosis that typically happens as a result of a bacterial orfungal infection. The most common cause of caseous necrosis istuberculosis—a bacterial disease that leads to caseous necrosis in the lungs.
Fat Necrosis
Fat necrosis is necrosis that occurs in parts of the body that contain a lot of fatty tissue, such as the breast.
Fibrinoid Necrosis
Gangrenous Necrosis
Gangrene is tissue damage associated with infection,ischemia(insufficient blood flow), or both. It is a relatively rare condition with a high mortality rate and can have a massive impact on quality of life. Gangrenous necrosis is categorized as wet, dry, or gas.
Patterns of Necrosis
Liquefactive necrosis refers to dead tissues that decompose into a viscous liquid, sometimes appearing as a creamy yellow due to pus forming.
Caseous necrotic tissue has a cheese-like appearance. The necrotic tissue becomes yellowish-white and soft with a well-defined border around the affected area.
Fibrinoid necrotic tissue is usually not visible to the naked eye. When viewed under a microscope, inflammation and the buildup of a substance called fibrinoid can be seen in blood vessel walls.
With gangrenous necrosis, affected skin may appear blue or black. In the case of gas gangrene, the skin may appear brownish-red and appear bubbly due to subcutaneous pockets of gas. There may also be a foul-smelling discharge and a loss of sensation in the affected area.
Causes of Necrosis
Necrotic tissue forms when not enough blood—and the oxygen that blood carries—reaches the affected tissues.
Blood clots and blood vessel damage are just two of the many causes that can trigger necrosis. Injuries, infections, chronic diseases, and toxins that block blood flow to an area can cause necrotic tissue to form in that area.
Injury
Traumatic injuries can damage blood vessels and cut off blood flow to the surrounding bones and tissue areas. Anything from a car accident to falling from a ladder can result in a traumatic injury that triggers necrosis.
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Other injuries that can lead to necrosis include:
Infarction
Infarction is tissue death that occurs when not enough blood reaches the affected area.
Necrosis due to infarction is often the result of a blood clot, such as adeep vein thrombosis(DVT) that forms in a blood vessel and blocks blood flow to the surrounding area.If blood flow is not restored quickly, the cells are starved of oxygen and eventually die.
DVT usually happens in the legs (but can happen anywhere in the body). It can result in the loss of tissue below the site of the blockage if the blood vessel is completely blocked.
Infection
A wide variety of bacterial, viral, fungal, and parasitic infections can trigger necrosis. Even a minor cut or scrape that gets infected can lead to necrosis.
Some types of infection more commonly cause necrosis than others. In particular, the bacteria called group AStreptococcusis thought to be the most common necrotizing infection.
Bacteria that can result in necrotic tissue include:
Viruses that can lead to necrosis include:
Necrotic tissue due to infection is most often seen on the extremities, particularly the hands and feet, as well as the genitals.
Disease
Certain autoimmune diseases are known to cause necrosis, the most common of which issystemic lupus erythematosus(SLE). It’s thought that people who treat their SLE withcorticosteroidsare most at risk, as long-term use of corticosteroids weakens bones.
Toxins
Chemical agents, such as poison, venom, and certain recreational drugs are known to trigger necrosis.
Exposure toarsenic, a metal found in rat poison and contaminated groundwater, can trigger necrosis in the kidneys.Cocaine that is laced with a white chemical called levamisole is linked to kidney necrosis as well.
Venom injected into the skin from abrown recluse spider bitecan cause necrosis unless treated quickly. Bites and stings from numerous other creatures cause necrosis, including spiders, snakes, scorpions, and jellyfish.
Withincreased agecomes increased vulnerability to problems that can trigger necrosis, such as injuries and vascular disease.This makes your age one of the biggest risk factors for necrosis.
Abusing alcoholalso puts you at a greater risk of developing necrotic tissue. Alcohol is cytotoxic, meaning that it is toxic to your cells. Abusing heavy amounts of alcohol over time can kill liver cells and trigger necrosis in your liver.
Having anopen wound, such as anabscessorsurgical incisionheightens your risk of infection and therefore necrosis.Traumatic injuriesandinsect bitesare risk factors for necrosis as well.
Long-term use ofcorticosteroidssuch as prednisolone is associated with a higher risk of necrosis. Necrosis is a common complication of the autoimmune diseaselupus. People who treat their lupus symptoms with corticosteroids are at an especially greater risk.
Other conditions that increase the risk of necrosis include:
Symptoms of necrosis vary depending on where in your body the necrotic tissue has developed. For example, symptoms of necrosis in your kidneys include:
When necrosis stems from a wound, symptoms can include:
If you notice symptoms of necrosis, it is important to seek treatment immediately.
A complete blockage of blood flow is typically painful, and usually painful enough to make someone seek medical help immediately.
Treatment may include surgery to restore blood flow or to remove the damaged tissues, antibiotics to prevent or treat infection, or treating the burn or other issues that caused the initial damage.
Can you take care of necrosis on your own?There are no self-treatments for necrosis, and you should not attempt to treat it at home.If you notice signs of necrosis, you should see a healthcare provider immediately. Treatment for necrosis needs to be aggressive, and your healthcare provider will need to begin treatment quickly for it to be effective.
Can you take care of necrosis on your own?
There are no self-treatments for necrosis, and you should not attempt to treat it at home.If you notice signs of necrosis, you should see a healthcare provider immediately. Treatment for necrosis needs to be aggressive, and your healthcare provider will need to begin treatment quickly for it to be effective.
Once the blood supply has been restored, which may require surgery, any dead tissue can be removed.
Removal of Tissue
Removal of necrotic tissue (akasurgical debridement) prevents the spread of infection. Treatment could also involve the amputation of a limb.
Medication
Antibiotics or antifungal medicines are prescribed to fight the infection.
Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy uses a pressurized oxygen chamber to raise the level of oxygen available to your red blood cells. This may aid in wound healing however, the data is inconclusive.
Tetanus Immunization
Summary
What Is Avascular Necrosis?
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