Necrosis

Definition

Necrosis is the death of cells or tissues in a living organism, typically from ischemia, trauma, infection, toxins, or radiation, such as unlike apoptosis (programmed cell death), necrosis triggers inflammation.

Types

• Coagulative: Ischemic organ infarction (MI).
• Liquefactive: Brain infarct, abscesses.
• Caseous: TB granulomas.
• Fat necrosis: Pancreatitis, trauma to fatty tissue.
• Gangrenous: Dry (ischemia) or wet (infection).

Wound Necrotic Tissue

Slough (yellow/tan moist) and eschar (black/hard) must be removed for healing. Debridement options: autolytic, enzymatic, mechanical, sharp, biologic.

Nursing Interventions

Prevent by maintaining perfusion, turning, pressure redistribution, nutrition, glucose control. Treat infection and debride necrotic tissue. Monitor for sepsis.

NCLEX Relevance

Necrotic tissue must be removed for healing.