Background: Fingertip injuries with volar pulp tissue defects are challenging to manage due to the complex anatomy and critical role of the fingertip in sensory and motor functions. Traditional surgical approaches are associated with donor site morbidity, prolonged immobilization, and suboptimal functional outcomes. This study aimed to evaluate the efficacy of a conservative treatment protocol using artificial dermis and semi-occlusive dressing for these injuries. Methods: A single-center, prospective study was conducted on 31 patients with fingertip injuries involving volar pulp defects. The treatment protocol involved wound debridement, application of artificial dermis (Pelnac®), and semi-occlusive dressing (IV3000®). Outcomes were assessed using subjective questionnaires and objective measures, including fingerprint regeneration, sensory function, pain, and cosmetic appearance. The impact of injury characteristics on outcomes and treatment duration was evaluated. Complications were recorded, and patient satisfaction was assessed. Results: The mean treatment duration was 45.29 days (SD=17.53), with no significant differences based on injury characteristics. Complications were minimal, with only one case (3.22%) directly attributable to the treatment. Fingerprint regeneration was considerable (mean score=2.58, SD=0.67), with slightly better scores in bone-exposed injuries. Sensory disturbances were minimal, with no significant differences across injury types. Post-treatment pain was low (mean=0.45, SD=0.67), and cosmetic satisfaction was high (mean=4.09, SD=0.94). Overall patient satisfaction was high (mean=4.41, SD=0.67), regardless of injury severity. Discussion: This study demonstrates the efficacy of a conservative approach using artificial dermis and semi-occlusive dressing for fingertip injuries with volar pulp defects. The treatment protocol achieved favorable outcomes in tissue regeneration, sensory recovery, pain management, and cosmetic appearance while minimizing complications and morbidity associated with traditional surgical interventions. The high patient satisfaction across all injury types highlights the patient-centered nature of this approach. Conclusions: The conservative treatment protocol using artificial dermis and semi-occlusive dressing is a promising strategy for managing fingertip injuries with volar pulp defects. This approach harnesses the body's regenerative potential, minimizes surgical morbidity, and achieves excellent functional and aesthetic outcomes. Further research is needed to optimize treatment protocols and investigate long-term outcomes.

Background: This study conducts a comparative historical analysis of two significant drug crises: the opium epidemic in 19th-century Qing Dynasty China and the ongoing opioid crisis in the United States, aiming to extract applicable lessons for current global drug policies. Methodology: A historical case study approach was employed, integrating examinations of historical records, policy documents, and contemporary data to compare the development, impact, and responses to these crises within their respective contexts. Results: The analysis reveals significant parallels in socioeconomic impacts and governmental challenges. Key differences include the evolution from predominantly prohibitionist approaches in Qing China to more comprehensive public health-oriented strategies in the U.S. The study highlights the critical role of national power, particularly military capability, in effectively addressing drug crises. Conclusions: The findings underscore four key lessons: (1) Purely prohibitionist approaches often lead to unintended consequences such as black markets and increased criminal activity; (2) Addressing underlying socioeconomic factors contributing to drug abuse is crucial; (3) Aggressive anti-drug policies can escalate into severe diplomatic tensions, necessitating careful consideration of international relations in policy formulation; (4) A nation's military and economic strength significantly influences its ability to implement effective drug policies and resist external pressures that may exacerbate the crisis. These insights suggest that effective management of drug crises requires a balance of strong domestic policies, international cooperation, and maintenance of national power to ensure policy autonomy.

Background: This study aimed to investigate the impact of the COVID-19 pandemic on breast reconstruction trends in the United States, focusing on implant-based and autologous techniques, as well as the timing of reconstruction (immediate vs. delayed). Methods: A retrospective analysis of data from the American Society of Plastic Surgeons' National Plastic Surgery Statistics from 2015 to 2022 was conducted. Annual trends in breast reconstruction procedures were analyzed, comparing the pre-pandemic (2015-2019) and pandemic (2020-2022) periods. Results: The total number of breast reconstructions increased from 106,338 in 2015 to 151,641 in 2022. The proportion of implant-based reconstructions decreased from 81.41% pre-pandemic to 76.51% during the pandemic (p < 0.001), with a notable rise in direct-to-implant procedures from 10.37% to 19.12% (p < 0.001). Autologous reconstructions increased from 18.59% to 23.49% (p < 0.001). Among autologous techniques, DIEP flaps remained the most popular. Immediate reconstruction rates increased from 72.61% pre-pandemic to 75.57% during the pandemic, while delayed recon-struction rates decreased from 27.39% to 24.43% (p < 0.001). Conclusions: The COVID-19 pandemic has significantly influenced breast reconstruction trends in the United States, with a shift towards autologous techniques, particularly DIEP flaps, and an in-crease in immediate reconstructions. These changes may reflect adaptations in surgical practice and decision-making processes in response to the unique challenges posed by the pandemic. Further research is needed to assess the long-term outcomes and patient satisfaction associated with these trends.