Bruce Ruben's blog

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NPWT affixed to a lower extremity wound

by Bruce E. Ruben MD

Little has been shown by specific randomized controlled trials to effectively speed the healing of a non-healing wound. Biologically, the human body is capable of healing once constitutional barriers are relieved. These barriers include venous and arterial insufficiency, nutritional deficiency, deep-seated infection, and environmental barriers such as repetitive trauma.

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Nutrition and protein intake

by Bruce E. Ruben MD

A day doesn't go by that I'm not bombarded with information on the newest diet, the latest exercise trend or the fastest way to get in shape. My email inbox opens with message subjects like "click here to drop 10 pounds fast" or "how to get a Kardashian body without surgery." I overhear women at a local breakfast haunt order egg whites instead of whole eggs, because they contain less fat and they are worried about gaining weight. How about the latest craze of ordering sandwiches wrapped in lettuce because everyone is afraid of the dreaded carbohydrates? Our culture is so focused on losing weight, getting in shape, and looking like the latest model on the cover of Vogue or GQ that we have lost sight of what is healthy.

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writing online review

By Robert Striks, Special Writer, Encompass HealthCare & Wound Medicine

I know, I know. You can get more bees with honey than vinegar. If you don’t have anything nice to say, don’t say it. If you want to be happy, give up your need to be right.

But all those adages were created before the Internet. In those good old days, if you were an unsatisfied patient, you either confronted the doctor or the staff personally, or you switched doctors.

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Health Care Costs

by Bruce E. Ruben MD

Have you noticed that in the fictional future, such as in the Star Trek universe, nobody uses money to pay for medical care? When you get sick, a starship medical officer scans you with a handheld diagnostic device, and then injects you with the perfect cure. No copays or deductibles. No making copies of your driver's license and insurance card. No reimbursements from insurance companies. And no explanation is ever given for how such a free society exists in the future.

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hand wound

by Bruce E. Ruben MD

A non-healing wound is generally defined as a wound that will not heal within four weeks. If a wound does not heal within this usual time period, the cause is usually found in underlying conditions that have either gone unnoticed or untreated. In general, there are five reasons why wounds will not heal and more than one of these conditions can be operating at the same time.

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doctor and patient

by Bruce E. Ruben MD
is a bunch of pivotal moments that move you on to the next phase. Like the moment you realize you're no longer a child. Or the moment it becomes clear that you have to change jobs. Later on, it's when you admit you can no longer maintain your home. And for many of us, there will be the moment you come to grips with the fact that you can no longer care for yourself without help.

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By Robert Striks, Special Writer, Encompass HealthCare & Wound Medicine

There's a funny scene in the Marx Brothers movie, "Horse Feathers," where Chico tells Harpo how to escape from the room they are locked inside by using a rope. Chico instructs Harpo to tie one end of the rope to the bed and then throw the other end of the rope out the window. "Tie on the bed, throw the rope out the window," he repeats. Haplessly, Harpo takes the tie he was wearing around his neck, places it on the bed and then throws the entire escape rope out the window.

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Scab

by Bruce E. Ruben MD

In the beginning, long before Johnson met Johnson and Band-Aids were invented, primitive men and women suffered minor cuts and abrasions and probably left them uncovered to heal. After all, the bleeding had stopped, a scab eventually formed and experience had taught them that their skin would heal in a week or two. So there was no great rush to find a use for those puffy, cottony, soft, white plants growing in the fields just yet.

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by Bruce E. Ruben MD

hippocratic_oath.jpg"As to diseases, make a habit of two things – to help, or at least, to do no harm."
– Hippocrates

This particular blog is not necessarily intended to educate, but to be a thinking piece that asks more questions than it answers.

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patient comorbidities in health history

by Bruce E. Ruben MD

In order to heal a wound, the body needs oxygen, nutrients, energy and a fully functioning vascular system that brings those resources to the wound and takes waste products away from the wound.

So it follows that any medical condition that diverts those resources from a wound could be considered a comorbidity or cofactor that inhibits wound healing.

There are hundreds of specific medical conditions that can inhibit or even prevent wounds from healing. Below are some of the more general and easily identifiable conditions.

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