OVERVIEW

Wounds of the foot and lower leg rarely heal in isolation. Dr. Pavelescu's surgical training in reconstruction, deformity correction, and limb salvage lets him treat the cause of a chronic wound, not just its surface. This might be a Charcot deformity, a bony prominence, a tight Achilles tendon, venous disease, or poor perfusion. Once the underlying problem is addressed and the wound bed is ready, advanced therapies can be added to speed closure:

• Skin substitute grafts and cellular/tissue-based products:

  • Dr. Pavelescu uses a variety of products, each tailored to your particular situation and wound. These products provide a scaffold or biologic stimulus for wounds that have stalled despite good standard care, including diabetic foot ulcers, venous leg ulcers, and surgical or post-debridement wounds. Dermal templates can help cover exposed tendon or bone and prevent major complications such as limb loss.

• Platelet-rich plasma (PRP):

  • Autologous platelet rich plasma, drawn from the patient's own blood, and applied to a clean, well-perfused, non-infected wounds, or as an adjunct after surgical debridement or reconstruction. The extracted platelets release PDGF, TGF-β, VEGF, and other growth factors to support healing.

• Fluorescence wound imaging:

  • Point-of-care, non-invasive, imaging modality that uses violet light to make bacteria-produced porphyrins fluoresce. This technology can reveal bacterial burden and guides sampling and debridement. Dr. Pavelescu utilizes this technology as a supplement to his clinical judgment, to help decide when a wound is truly "clean" before applying a graft or initiating and advanced treatment modality.

These therapies are used within a structured plan:

• A full limb assessment: circulation, infection and bone involvement, deformity, and diabetes and nutrition status.

• Referral for revascularization when blood flow is inadequate.

• Surgical debridement and infection control.

• Offloading, plus surgical correction of the mechanical cause where needed.

• Advanced therapies once the wound is ready, with measured progress at regular weekly visits.

• Long-term prevention, including therapeutic footwear and custom orthotics.

Dr. Pavelescu coordinates with vascular, infectious disease, and primary care colleagues so each patient gets an individualized plan aimed at keeping them on their feet.