Skin Necrosis: Treatment and Healing After Injury

Necrosis of the skin at the wound site?

After the car accident on April 1st, I had abrasions on the dorsum of my right foot and went to the clinic for a dressing change.
Today, the doctor mentioned that there is a patch of necrotic tissue that needs to be removed.
The process was extremely painful, and it was difficult to remove.
I would like to ask: 1.
Will this necrotic tissue fall off on its own? 2.
Will not removing it affect the healing process? 3.
Can I wait until the wound heals a bit more before having it removed?

zero, 20~29 year old female. Ask Date: 2020/04/08

Dr. Lü Mingchuan reply Plastic Surgery

Hello; if it does not fall off naturally, subsequent debridement may be necessary, and skin grafting might be required.
It is recommended to follow up with the plastic surgery outpatient clinic.
The Ministry of Health and Welfare Changhua Hospital cares about you.

Reply Date: 2020/04/08

More Info

Skin necrosis, or the death of skin tissue, can occur after an injury due to various factors, including inadequate blood supply, infection, or severe trauma. In your case, following a car accident, it is crucial to address the necrotic tissue properly to promote healing and prevent complications.

1. Will the necrotic skin naturally fall off?
Necrotic tissue does not always fall off on its own. In some cases, the body may gradually absorb the dead tissue, but this process can take time and may not be complete, leading to potential complications such as infection or delayed healing. If the necrotic tissue is extensive or if it is causing pain and discomfort, medical intervention is often necessary to remove it. This procedure, known as debridement, can be performed surgically or through other methods, depending on the severity and location of the necrosis.

2. Will not removing it affect healing?
Yes, leaving necrotic tissue in place can significantly hinder the healing process. Dead tissue can serve as a breeding ground for bacteria, increasing the risk of infection. Additionally, necrotic tissue can impede the formation of new, healthy tissue, leading to prolonged healing times and potentially resulting in chronic wounds. Therefore, it is generally recommended to remove necrotic tissue to facilitate proper healing and recovery.

3. Can I wait until the wound heals a bit more before removing it?
While it may be tempting to wait for the wound to heal further before addressing the necrotic tissue, this is not advisable. Delaying the removal of necrotic tissue can lead to complications, including infection and further tissue damage. It is essential to consult with a healthcare professional who can assess the wound and determine the best course of action. If the pain during the removal process is significant, your doctor may be able to provide pain management options or perform the procedure under anesthesia to minimize discomfort.

In addition to addressing the necrotic tissue, proper wound care is crucial for healing. Here are some general recommendations for managing a wound with necrosis:
- Keep the wound clean: Gently clean the area with saline or mild soap and water to prevent infection.

- Dress the wound appropriately: Use sterile dressings to protect the wound from external contaminants. Depending on the severity of the necrosis, your doctor may recommend specific types of dressings that promote a moist healing environment.

- Monitor for signs of infection: Watch for increased redness, swelling, warmth, or discharge from the wound. If you notice any of these signs, contact your healthcare provider immediately.

- Follow medical advice: Adhere to your doctor's recommendations regarding wound care, medication, and follow-up appointments.

In conclusion, addressing skin necrosis promptly and effectively is vital for optimal healing. Do not hesitate to seek medical attention for proper evaluation and treatment. Your healthcare provider can guide you through the process and ensure that your wound heals as efficiently as possible.

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