Gap ExMC 4.07: Limited wound care capability to improve healing following wound closure (Closed)
Last Published:  07/30/21 01:05:31 PM (Central)
Responsible Element: Exploration Medical Capability (ExMC)
Status: Closed
Closure Rationale
Gap Closure Synopsis
This gap existed to explore the development of methods and technologies for wound care capabilities. The Exploration Medical Condition List (EMCL) identifies skin abrasions/lacerations and burns as potential risk areas.  Both ground and space animal studies have identified a number of potential issues associated with delayed wound healing, non-healing, or excessive fibrosis; however, no areas for technology development were identified to be able to treat the identified conditions on the EMCL. Evidence of several emerging treatment modalities is document in the FY13 Gap Review Presentation for Gap 4.07 and is summarized below.


Current wound healing products available in the medical community fall into two categories.  First are wound-healing agents, including fibrin sealants, which contain certain plasma-derived coagulation factors: fibrinogen and thrombin and the anti-fibrinolytic agent, aprotinin. Fibrin sealants are used to expedite wound healing and to seal cut tissues, control bleeding and permit uncomplicated healing following surgery.  These types of products are sold over the counter or by prescription. 

 

The second category is tissue-engineered products, which can be acellular or cellular.  Acellular products are absent of biological cells and consist of a matrix that function by binding to the host, allowing matrix-cell interactions.  Due to its porous nature, the matrix allows host cells to infiltrate and can contain virus vectors or plasmids that transcribe and translate the in-built DNA leading to secretion of specific growth factors or hormones.  These growth factors carry out their specific functions by stimulating host cells to enhance wound healing.  The matrix contains ECM-proteins such as collagen, hyaluronic acid, and fibronectin, thus ensuring biocompatibility.


Cellular products contain living cells, often fibroblasts and keratinocytes embedded in a collagen or polyglactin scaffold forming an epidermal layer skin substitute.  Autologous cells are used in these products to minimize the risk of rejection.  Autologous keratinocytes are derived from progenitor cells from dermal sheets in the outer root surrounding hair follicles or from epithelial cells obtained via a biopsy of the recipient's skin.  A permanent autologous epidermal skin graft is applied that functions as a reliable barrier and promotes the formation of granulation tissue.

 

Rationale for Closure

This gap has been on hold and is now ready to be closed as there is limited research and too few data to support that there is a different mechanism to wound healing during spaceflight.  The integration of data on impaired hard and soft tissue healing during and after spaceflight will continue with collaboration with the Human Health Countermeasures (HHC) element through two of their gaps: Gap IM5, for the characterization for immune changes, and Gap Fracture 1, for the review of evidence for impaired wound healing.  As the technologies for improved wound healing evolve, ExMC will identify new advancements in care via the ExMC gap for technology watch, Gap 3.03.

 

Tasks and Supporting Reports Completed

There were no ExMC tasks associated with this gap.


Closure Documentation:
No Closure Documentation Available
Description

Explore the development of methods and technologies for wound care capabilities.

Target for Closure
No Target for Closure available.
Mappings
Risk Risk of Adverse Health Outcomes and Decrements in Performance Due to Medical Conditions that occur in Mission, as well as Long Term Health Outcomes Due to Mission Exposures
You are here! Gap ExMC 4.07: Limited wound care capability to improve healing following wound closure (Closed)

Multi-Disciplinary Research Plans

Documentation:
No Documentation Available