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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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.

They are:

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doctor and patient

by Bruce E. Ruben MD

"Any natural, normal human being, when faced with any kind of loss, will go from shock all the way through acceptance."
Elisabeth Kubler-Ross

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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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