Ask what a mile driven flat does to a tyre and the answer is all on the inside, where nobody looks. With no air holding it up, the wall folds over and the bead gets dragged sideways off its seat, rolling under the rim instead of sitting on it. The inner liner, which is the airtight skin inside, is then rubbing against itself and against the rim edge at road speed.
Break one of those tyres down and it tells you the whole story. A grey ring of rubber dust has collected in the bottom of it, the liner has gone matt where it should be smooth, and the bead has picked up a flattened band that will never seal cleanly again. None of that shows from the outside, which is why a tyre that has been run down gets inspected off the rim rather than pumped up and waved on its way. Out here the distance is what finishes it, not the puncture.
An MOT advisory about a tyre is a warning with a date on it. We can look at the car where it sits, in Estover or West End, and give you a straight view, then fit the replacement there and then if that is what it needs. Valve in Norwood Road, balance in Station Road, pressures before we go. The wheel comes off in Wimblington Road, not on a ramp in Chatteris.

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Distance is the particular problem in this part of Cambridgeshire. A tyre that goes down on the A141 or out on one of the droves is a long way from anywhere with lights and a hard surface, and the instinct is always to press on towards Chatteris or towards home. That drive is usually what turns a repair into a replacement, and it is the part a callout removes.
The car had come several miles on a soft rear rather than stop on an unlit road, which is an understandable choice at night. Off the rim the liner was scuffed and grey and the bead had rolled. There was a repairable nail in it, but the tyre around the nail was finished.
A tyre that has been run flat tips a fine grey powder onto the floor when it comes apart. That powder is the liner. Once it is coming away in that quantity the tyre no longer has an airtight surface for a patch to bond to, whatever the tread depth says.
A wheel off a car on Norwood Road held air for a minute and then sighed it back out around the rim. The bead had a flat section from being run down. New tyre, and the rim flange cleaned back at the same time so the new one had something true to sit on.
Possibly not, and the puncture is no longer what decides it. What matters is whether the inner liner has been ground away and whether the bead rolled off its seat while the car was moving.
It comes apart and shows you. The liner turns matt and grey where it ought to be smooth, there is loose rubber dust inside, and part of the bead has been squashed flat.
Pressure hides all of it. The outside of a tyre that has been driven down can look entirely normal while the surface a patch needs to bond to has already been destroyed.
Stop while it is still soft rather than fully flat, get the car well clear of the carriageway and stay out of it if the road is a fast one. Standing still costs you a wait. Moving costs you the tyre.
Sometimes. Running on the flange scores it and can dent it, and a damaged flange leaks around the bead afterwards even with a brand new tyre on it. The rim gets checked before anything is fitted.
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