title: Manual suturing quality at acceleration levels equivalent to spaceflight and a lunar base.
abstract: BACKGROUND
  Cutaneous wounds, either from injuries or as a result of surgical incisions, are a likely possibility that future space medicine specialists will need to address. While there has been some prior study of manual suturing in microgravity (0 G), there has been no study of manual suturing in reduced gravity consistent with that of the Moon.
  
  
  METHODS
  Six separate operators with varying degrees of surgical experience (four trained surgeons, and two non-surgeons) attempted to manually suture wound phantoms during the reduced gravity phases of parabolic flight simulating either 0 G or lunar gravity (0.16 G). Each operator subjectively evaluated the difficulty and relative speed in performing the same task in different environments, serving as their own internal control. There were 20-s periods of 1 G that were carefully timed for each surgeon to compare to the approximately 20 s available for each parabola of either 0 G or 0.16 G.
  
  
  RESULTS
  Six periods of 1 G were used as controls to perform manual suturing of the phantoms. There were 51 parabolas of 0 G and 67 parabolas of 0.16 G performed by the six operators. As judged subjectively by the operators themselves and by group inspection of the sutured phantoms, there was no qualitative difference in the adequacy of wound closure as judged by suture placement accuracy and wound coaptation. There was consensus, though, that suturing in microgravity was significantly slower, as has been noted in more complex surgical studies.
  
  
  CONCLUSIONS
  The technical aspects of wound management during exploration-class missions in prolonged microgravity or lunar missions with reduced gravity (0.16 G) will likely not present challenges beyond those faced in addressing the tremendous logistical and training obstacles to providing experienced and equipped surgeons on-board such a mission.
authors.affiliation: Regional Trauma Services, Calgary Health Region, Calgary, Alberta, Canada. USA.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Kirkpatrick
authors.forename: Charles R
authors.initials: CR
authors.lastname: Doarn
authors.forename: Mark R
authors.initials: MR
authors.lastname: Campbell
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Barnes
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Broderick
mesh_terms: D000337:Aerospace Medicine; D018480:Astronauts; D006801:Humans; D018472:Hypogravity; D010820:Physicians; D013536:Suture Techniques; D018474:Weightlessness Simulation; D014947:Wounds and Injuries / Q000628:therapy*