How to treat avascular necrosis naturally
Necrosis (tissue death)
What does medicine mean by necrosis?
An extensive occlusion of fine, deep-lying vessels leads to a reduced blood flow to the affected tissue. The vascular occlusion causes the cell death of the tissue layers and the resulting skin necrosis, which offers an ideal environment for bacterial colonization. Certain bacteria, which can survive well without oxygen, promote the formation of what is known as gangrene, also known as gangrene. As a result, insoluble gases accumulate in the deeper fatty tissue and neighboring structures are attacked.
What types of necrosis are there?
In the wound area, a distinction is made between dry and moist necrosis. The two forms often arise not only from the reduced blood flow as a result of an arterial peripheral occlusive disease (PAD), a circulatory disorder that is increasingly associated with diabetes mellitus.
First of all, pain occurs in the affected wound area; if left untreated, such as by surgical vasodilation, the less perfused tissue will eventually become numb and feel numb. Gradually there is a dark, bluish discoloration and the death of the cell layers.
When the dead tissue dries up, this form of necrosis is called dry gangrene. If germs infect the disintegrated tissue, it remains rather soft and begins to smell unpleasant, here we are talking about a damp gangrene.
Depending on which type of tissue is affected, necrosis can be divided into other forms:
- Coagulation necrosis is the most common dry form of necrosis and can occur in all tissues except the brain. Coagulation or coagulation necrosis occurs when the blood flow to an organ or tissue is no longer guaranteed. A good example of this is the heart attack: parts of the heart muscle are no longer supplied with sufficient oxygen and subsequently die. The cell components and certain proteins are immediately transferred into the blood and serve as essential inflammation parameters in the context of heart attack diagnostics. Coagulation necrosis can also affect other organs such as the liver, spleen or kidneys. Coagulation necrosis can also be caused by burns of the skin or mucous membranes with an acid or alkali.
- If the organ affected by cell death is mainly made up of fat and only a little protein, it is a softening necrosis, a so-called wet colliquation necrosis. Organs with such a structure are the brain and the pancreas. For example, a stroke or severe inflammation of the pancreas can lead to colliquational necrosis. The affected tissue becomes soft, liquefies and the cell remains with all their liquid components collect in a cavity.
- We speak of fibrinoid necrosis when elastic fibers or collagen fibers die off, as is the case, for example, with an inflammation of the blood vessels. Such necrosis occurs as a result of an autoimmune reaction, in which defense cells attack the immune system and destroy the body's own cells.
- Adipose tissue necrosis is the death of fat cells, including through trauma such as operations, bruises or bruises. An incorrect injection of medicines or an acute inflammation of the pancreas can also cause adipose tissue necrosis.
- Bone necrosis results from the occlusion of a blood vessel that is responsible for supplying a certain section of bone. As a result of the reduced blood flow, bone loss occurs, which, however, does not result in an infection, and possibly even a functional failure. The damage can heal without consequences, but it can also lead to permanent impairment of skeletal function.
What special forms of coagulation necrosis are there?
Special forms of coagulation necrosis are casing necrosis in the course of tuberculosis and so-called gangrene. Gangrene, also known as gangrene, is probably the most well-known form of necrosis. It occurs primarily in the case of absolute vascular occlusions in the legs, such as a smoker's leg or a diabetic foot. However, such gangrene can also occur in severe forms of pressure ulcer, the advanced bed sores. First, coagulation necrosis occurs, depending on whether the dead tissue liquefies or dries, becomes black and leathery, we speak of a wet or a dry gangrene. Characteristic features of gangrene are tissue shrinkage and blackish discoloration.
What are the symptoms of necrosis?
The primary characteristic of necrosis is severe pain. Areas of the body that have poor blood flow or nerve disorders, for example as a result of an operation or a chronic illness, only hurt to a limited extent or not at all. The affected tissue is severely swollen, reddened, overheated and tends to discolour the surface of the skin. Blistering, crackling in the affected wound area or the formation of ulcers are also not uncommon. If the deep tissue is necrotic, the surrounding tissue including the adjacent fascia is also affected, but the muscles are spared. The clinical picture is accompanied by a high fever, changes in consciousness and a racing heart.
Which parts of the body are particularly at risk for necrosis?
Particularly parts of the body where strong pressure is exerted on the skin are at risk for the development of necrosis. Both forms of necrosis are often caused by a reduced blood flow in the context of a peripheral arterial occlusive disease, which occurs increasingly as a secondary disease in long-term diabetes mellitus patients and mainly affects the feet. But the tailbone is also a particularly susceptible point for the development of a bed sore and subsequent necrosis when immobile.
What are the causes of necrosis?
The causes of such cell death are, for example, a lack of oxygen as a result of circulatory disorders, chemical burns, burns, frostbite, injuries or infections. Movement disabilities in the course of surgical interventions, being bedridden, being very overweight or taking certain medications that suppress an excessive immune response of the immune system. The process of cell death with the associated tissue destruction is irreversible.
What is the course of necrosis?
The mortality rate for severe necrosis is around 30%. Old age, delayed diagnosis and treatment, and inadequate surgical therapy worsen the prognosis.
When should I see a doctor with necrosis?
If you notice a wound in yourself or in your loved ones and acquaintances that simply does not want to heal or has a strange discoloration, you should definitely consult a doctor. With proper wound healing, a renewal process of the skin should start after a few days. Even if you are bedridden or if you have diabetes mellitus, it is advisable to have open injuries examined by a doctor in order to identify the onset of necrosis in good time. The same applies to people who belong to the risk group for necrosis or wound healing disorders. You should also urgently have pain in the abdomen or in the area of the bones that lasts for several days. If you feel sick and have a fever or chills, it is also advisable to get to the bottom of the cause.
How does the doctor diagnose necrosis?
Your doctor can determine the necrosis as part of a clinical examination, as well as on the basis of a blood and wound culture. In addition, the inflammation process in the X-ray image shows gas accumulations in the soft tissue. The muscles are only affected in extremely rare cases.
How can necrosis be treated?
The top priority is to eliminate the triggering cause. In the case of a peripheral arterial circulatory disorder, this should be improved or even restored.
Treatment should be done as early as possible and primarily through surgical removal. The extent to which the doctor has to operate and how much tissue he removes always depends on the necrosis and the affected area. As a support, your doctor will order intravenous antibiotics to prevent infection. Here there is usually a combination of at least two preparations in order to cover the entire bacterial collective. Blistering, small-area bleeding from the mucous membranes or the spread of infection via the bloodstream require immediate surgical opening and removal.
The rehabilitation of the wound bed should be repeated every one or two days by means of surgical removal in order to create a proper wound environment to promote healing. This surgical procedure for cleaning wounds is known as debridement. The aim is also to bring the dead tissue into the condition of a fresh wound in order to prevent the possible spread of infection. In particularly severe cases, it may even be necessary to amputate an extremity.
What are the complications of necrosis?
Depending on the cause, the state of health and the affected area, various complications and complaints can occur. In most cases, there are no complications in healthy people with an otherwise intact immune system and timely therapy.
However, if the internal organs are affected by the lack of oxygen, permanent damage can remain. The quality of life is also significantly reduced due to illness. Superficial necrosis can cause annoying scars that can negatively affect the aesthetic appearance.
What are the consequences of necrosis for those affected?
Necrosis can lead to blood poisoning or even streptococcal toxic shock syndrome. In particularly serious cases, amputation of the affected limb is also necessary.
Can I prevent necrosis?
First and foremost, you should pay attention to a healthy lifestyle with a balanced diet and sufficient physical activity. Obesity, alcohol and nicotine promote the occurrence of vascular diseases and thus promote tissue necrosis. In addition, alcohol and nicotine also have a direct negative effect on the immune system and wound healing. Even two hours after the last cigarette, the blood flow in the affected wound area is significantly reduced, so you should strictly refrain from nicotine after surgery.
After surgical interventions or as part of a chronic illness, the nutrient requirement is significantly higher than usual. Include sufficient proteins and vitamins (especially vitamins C, E and A) in your diet for optimal wound healing. The nutritional status has an immense influence on wound healing, so there should be no malnutrition under any circumstances.
In order to avoid diabetic foot syndrome, a complication of diabetes mellitus, you should ensure that your blood sugar level is optimally controlled if your blood sugar level is chronically high. Appropriate footwear and regular foot inspections must also be observed in this context, because such a diabetic foot syndrome can very quickly lead to open ulcers and gangrenous necrosis.
What is the difference between necrosis and apoptosis?
In contrast to apoptosis, necrosis is abnormal tissue destruction. The programmed cell death, within the framework of apoptosis, describes the "normal", controlled death of individual cells and affects the entire organism. This process is, among other things, an essential process for cell renewal.
How much does necrosis treatment cost?
With standard procedures and medically indicated therapies, you usually do not have to reckon with any costs.
Do the health insurance companies cover the costs of treating necrosis?
In Austria, the health insurance carriers take over all necessary and appropriate therapies. In principle, your treating doctor or the responsible hospital will settle the accounts directly with the health insurance company, but you may have to pay a deductible with individual social insurance providers.
About the author: Dr. med. Christiane Brunner
Specialist in General Medicine
As a general practitioner, my main concern is to support you in the truest sense of the word in your everyday life. What can you do to stay healthy? And how do you get well again if you are ill?
I combine traditional medicine with natural healing methods, acupuncture and massage in order to find the therapy that best suits you and your life situation.
It is particularly important to me that I meet you as a person. At eye level, very direct, close and personal - for an uncomplicated togetherness with humor. Because laughter and a small dose of lightness are the best ways to go through life healthily.
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