Spaceflight Research: The potential to improve wound care in our Clinics M. Mark Melin MD, FACS, RPVI, FACCWS
M Health Fairview, Wound Healing Institute, South Campus Adjunct Associate Professor, Department of Surgery, University of Minnesota Minneapolis, MN
Heather Hettrick PT, PhD, CWS, AWCC, CLT-LANA, CLWT, CORE Professor, Nova Southeastern University, Ft. Lauderdale, Florida
The American Vein & Lymphatic Society (AVLS) meeting in Denver brings an “elevated” component to the conference as a distinguished Wound Care Faculty discusses benchtop to clinical care and terra firma to Low Earth Orbit (LEO) topics aboard the weightless laboratory of the International Space Station (ISS). The session begins with an up-to-date data review of venous leg ulcer management, an intriguing discussion of the microcirculatory component of wound resolution and a deep dive into the endothelial glycocalyx: the historical perspective, glycocalyx recognition, the paradigm-shifting revision of the Starling Forces, and glycocalyx contribution to systemic health. The extensive and growing recognition of the functions of the glycocalyx, the revision and modification of the Starling principle forces, and paradigm shift in understanding that nearly 100% of interstitial fluid is returned to the central venous circulation by lymphatic pathways1 has contributed to a renaissance in lymphatic research and treatment options. The recognition that an intact glycocalyx imparts healthy microcirculatory function, while “thinning” and/or “shedding” of the glycocalyx is recognized as part of the disease process or aging, resulting in microcirculatory dysfunction. Shedding of the glycocalyx has been recognized in diabetes, arterial and
Frank Aviles Jr, PT, CWS, FACCWS, CLT-LANA, ALM, AWCC, DAPWCA
Wound Care Service Line Director, Natchitoches Regional Medical Center, Louisiana
venous hypertension, tobacco abuse, COVID-19 infection, pre-eclampsia, sepsis, and other states of acute and chronic inflammation2,3,4,5,6,7,8,9. Lymphatic contractility benchtop research will be reviewed, as will the lymphatic focus for improving wound care outcomes. Countermeasure management of venous and lymphatic dysfunction is highlighted by the impact of flavonoids, specifically hesperidin – diosmin, which has a long and bountiful history of benchtop and clinical trials in Europe. Emerging technologies in wound care and potential venous interventions will be discussed, with the morning session finale promising a robust discussion of astronaut health, adaptability to long-duration spaceflight, and reports on how environment and genetics impact astronaut health. The wound care session is an up-to-date, “Show Me the Data” session from some of the nation’s leaders in their fields. A unique evening event to capitalize upon the current interest in spaceflight and human physiology will be held at the Colorado Air and Space Port. The event will explore the data to date for venous and lymphatic alterations in function during the weightlessness of space travel. This area of research has a specific impact on astronauts during long-duration space missions, both in low-Earth orbit and planned missions to the moon and Mars. 16
