The concept of combat in space may appear to some as a future problem or a fictional concern
nevertheless, surgical preparation for injury or disease in even these unlikely or uncommon scenarios is prudent. The impact of distance, time, material, and capacity become acute in these settings. In addition to these challenges, the ability to conduct routine, emergent, anesthetics, and surgical care in null or microgravity complicates this further. Simulation training for these eventualities will be critical in support of these future explorations.