Necrosis on the heel

Necroses of the heel are caused by so-called pressure necroses. These are mainly found in lying and only slightly mobile people and are also called pressure sores. When lying on the back, for example, permanent pressure is exerted on the rear heel.

The supplying blood vessels are squeezed and the tissue is not sufficiently supplied with oxygen, which leads to necrosis. Pressure necrosis of the heel is also possible under other circumstances, for example, when the patient is constantly standing or in wheelchairs. This is treated by relieving the affected area. Depending on how advanced the necrosis was and whether deep-reaching wounds (ulcers) have already formed, skin covering may also be necessary.

Necrosis of the Achilles tendon

In the context of Achilles tendon inflammation or circulatory disorders of the Achilles tendon, parts of the tendon may die. Such a necrosis is manifested by severe pain and a restriction of movement. An Achilles tendon necrosis is usually diagnosed by an MRI, where the dead area is white. Treatment is by surgical debridement, i.e. removal of necrotic tendon fibers. Depending on the extent of the disease and the surgically created substance defect, it may be necessary to reinforce the Achilles tendon with other muscle tendons of the body (e.g. plantaris tendon).

Necrosis of the coccyx

Similar to heel necrosis, the most common cause of sinking tissue on the rump is also pressure necrosis. Since bedridden patients often lie on their backs for weeks on end with little movement, positioning or mobilization by relatives, nursing staff or caregivers is absolutely necessary. The permanent pressure on the coccyx leads to necrotic remodeling due to lack of oxygen.

In the long term, this leads to a deep and poorly healing wound (ulcer). Especially in the case of the coccyx, such a wound can take on extreme dimensions and become life-threatening for the patient. The reason is that the ulcer has a high risk of infection and at the same time there is hardly any tissue between the skin and bone, so that the ulcer is frequently observed to be involved.