About this Research Topic
Through the wound healing (WH) process, the body is able to repair damage due to wounds, trauma, burns and recreate the skin barrier to protect itself from the external environment and maintain its homeostasis. The healing process consists of a series of complex biological mechanisms, linked and/or partially overlapped, which must take place in a strictly controlled modality and timeline. Alterations of mechanisms and/or their timeline led to impaired healing, with a series of pathologic conditions ranging from chronic ulcers to fibrotic scars.
On Earth, remarkable progress has been made in understanding the cellular and molecular mechanisms of WH, but many of them still remain unknown. The process of WH in Space, that is in unloading conditions, is almost completely unknown.
Future space exploration programs require long-duration missions beyond LEO. In these missions, health emergencies onboard cannot be excluded, while medical evacuation times to Earth might become too long and the communication lag would render useless to guide the crew actions remotely. Therefore, medical care planning for future exploration missions should incorporate the concepts of trauma care, emergency surgery, wound management, and healing. As WH is critical to survive trauma or surgery, studies on repair processes in Space are required.
The relatively few studies on WH in Space show microgravity-induced changes in mechanisms underlying tissue repair. The European Space Agency (ESA) created a Topical Team (TT) on “Tissue Healing in Space: Techniques for promoting and monitoring tissue repair and regeneration” with the aims to survey the existing literature, evaluate the results of the different studies, identify the possible alterations of the healing process in Space and suggest countermeasures (therapeutic and diagnostic tools), propose future studies and indicate the roadmap to approach the problem of WH in Space.
Based on the work done by the ESA-TT, this special issue aims to give an overview of the critical aspects in the management of injuries, burns, ulcers, surgical and non-surgical wounds in Space and suggest what countermeasures could be studied and developed.
The manuscripts should describe the main biological functions and underlying mechanisms involved in the healing process and speculate about the alterations that could occur in a Space environment due to unloading conditions and cosmic rays or other spacecraft related factors. Furthermore, possible countermeasures should be suggested. Specific themes could be:
· Platelets and Platelet Rich Plasma (PRP) in Space
· Inflammation and immune cells in wound healing
· Emergency surgery and traumatic wounds in space envirinment
· Fibroblasts and remodeling
· Neoangiogenesis in unloading conditions
· Epidermal cell function in the healing process
· The role of apoptosis in wound healing
· Wound healing and microbiome
· Stem cells and micro-graft application
· Physiological alterations affecting wound healing in Space
. In-flight procedures regarding wound healing
Keywords: Wound healing, Tissue regeneration, Wound management, Space, Space surgery
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