Tissue necrosis refers to the death of cells and tissues because of prolonged oxygen deprivation, infection or severe injury.<\/p>\n\n\n\n
It is the most extreme form of tissue injury and, if not treated promptly, may spread to adjacent healthy tissues. This can create a self-perpetuating cycle that enlarges the affected area and places the entire limb, or even the patient\u2019s life, at risk.<\/p>\n\n\n\n
Tissue necrosis may occur in a variety of clinical settings, including ischaemic gangrene in patients with diabetes or vascular disease, necrotising fasciitis caused by aggressive infections, radiation-induced necrosis in previously irradiated tissues, and tissue necrosis following trauma or surgery.<\/p>\n\n\n\n
The common underlying factor in all these forms is inadequate oxygenation. Necrotic tissue cannot be restored, but effective treatment of the surrounding tissue at risk, where cells remain viable but are close to irreversible injury, may determine the final outcome.<\/p>\n\n\n\n
The critical clinical objective in tissue necrosis is not only to remove tissue that has already died, which requires surgical debridement, but also to preserve the zone of tissue at risk surrounding the necrotic area.<\/p>\n\n\n\n
Within this zone, the cells remain alive but are exposed to severe hypoxic stress. If oxygenation is restored promptly, they may survive and contribute to healing. If it is not, they may also become necrotic, causing the affected area to expand.<\/p>\n\n\n\n
Another major concern is the risk of infection. Necrotic tissue provides an ideal environment for bacterial growth, particularly for anaerobic microorganisms.<\/p>\n\n\n\n
In a hypoxic environment, white blood cells are unable to perform their phagocytic function effectively. This impaired immune response allows the infection to spread and become more severe.<\/p>\n\n\n\n
The use of hyperbaric oxygen therapy in necrotising infections, such as gas gangrene, also known as clostridial myonecrosis, and necrotising fasciitis, is one of its most established applications and is recognized by the Undersea and Hyperbaric Medical Society (UHMS) as a Category I indication.<\/p>\n\n\n\n
Studies have reported lower mortality rates and fewer surgical debridement procedures in patients with gas gangrene who received hyperbaric oxygen therapy as an adjunct to surgical debridement and antibiotic treatment.<\/p>\n\n\n\n
In non-infectious forms of necrosis, including ischaemic and radiation-induced necrosis, the evidence focuses on preserving the surrounding tissue at risk and improving healing conditions after the surgical removal of necrotic material.<\/p>\n\n\n\n
In tissue necrosis, hyperbaric oxygen therapy is always used as an adjunct and never as an alternative to surgical debridement of necrotic tissue or appropriate antimicrobial treatment.<\/p>\n\n\n\n
Its clinical value centres on two principal objectives: preserving the surrounding tissue at risk and creating an antimicrobial environment within the affected area.<\/p>\n\n\n\n
In the zone surrounding the necrosis, the increased amount of oxygen dissolved in the plasma can reach cells that are close to the limits of survival, providing the oxygen required to resist further progression of necrosis.<\/p>\n\n\n\n
At the same time, elevated oxygen levels exert a direct bactericidal effect against anaerobic pathogens and enhance the phagocytic capacity of white blood cells, whose function is restored in a well-oxygenated environment.<\/p>\n\n\n\n
The frequency and total number of sessions depend on the type and severity of the necrosis.<\/p>\n","protected":false},"excerpt":{"rendered":"
What Is Tissue Necrosis? Tissue necrosis refers to the death of cells and tissues because of prolonged oxygen deprivation, infection or severe injury. It is … <\/p>\n