> ## Content Index
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# Cash Influences Research, 1 Important Podcast Guest, & All Things Vascular Anomalies
- URL: https://www.theplasticsfella.com/march-16th/
- Published: 2025-03-14T19:50:43.000Z
- Updated: 2025-03-15T21:44:37.000Z
- Description: Also: Proper propranolol dosing, calling expert reviewers for the textbook, & 3 recommended articles.
- Author: PlasticsFella
- Tags: thePlasticsPaper

#### In this week's edition

1. ****✍️** [****Letter from P'Fella**](https://www.theplasticsfella.com/march-16th/#a-letter-from-pfella)  
Research or marketing? The industry cash behind nerve allografts.
2. ****🤓** [****The Sunday Quiz**](https://www.theplasticsfella.com/march-16th/#the-sunday-quiz)  
New winners top the leaderboard!
3. [🖼️](https://emojipedia.org/framed-picture?ref=theplasticsfella.com) [****Image of the Week**](https://www.theplasticsfella.com/march-16th/#image-of-the-week)  
Clinical insights on vascular tumours.
4. 📘 [****Foundations Textbook**](https://www.theplasticsfella.com/march-16th/#foundations-textbook)  
Calling plastic surgery experts to contribute!
5. ****🎙️** [****Behind the 'Fella**](https://www.theplasticsfella.com/march-16th/#behind-the-fella)  
What should we ask Rod Rohrich?
6. 📖 [****What Does the Evidence Say**](https://www.theplasticsfella.com/march-16th/#what-does-the-evidence-say)  
What is the optimal dose of oral propranolol?
7. ****🔥** [****Articles of the Week**](https://www.theplasticsfella.com/march-16th/#articles-of-the-week)  
Vascular malformations, ISSVA classification, & The original 1982 classification of hemangiomas: with 1-sentence summaries.
8. 💕 [****Feedback**](https://www.theplasticsfella.com/march-16th/#feedback)  
Suggest ideas & give feedback!

## A Letter from P'Fella

**Research or Marketing? The Industry Cash Behind Nerve Allografts*

👋

****Hey Team!**  
  
Let's call it what it is: ****Nerve allograft researc**h is a tangled web of academia and industry cash. It’s a snapshot of a bigger struggle — clinical integrity versus commercial pressure.

**The Dirty Truth**

A recent [publication](https://journals.lww.com/plasreconsurg/fulltext/2025/03000/academic%5Finfluence%5Fand%5Findustry%5Ffunding%5Fin%5Fnerve.44.aspx?ref=theplasticsfella.com) in the PRS journal caught my eye. Nearly **80%** of the top **nerve allograft researchers** have pocketed industry cash, totaling over **$14 million** in the past decade. We're not just talking lunch money — some pulled in hundreds of thousands. If that doesn’t raise your eyebrows, you’re not paying attention.

![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/03/image-4.png)

[Source](https://x.com/prsjournal/status/1899445516120760830?ref=theplasticsfella.com)

Yes, industry dollars can drive innovation, but when **funding dictates research outcomes**, the integrity of the science takes a hit. Positive spin often overshadows solid, comparative evidence — leaving clinicians and patients to wonder what’s real innovation and what's just clever marketing.

**Real Winners or Real Risks?**

Sure, nerve allografts offer appealing perks — shorter operations and no donor-site complications. But without robust, comparative evidence, we're left wondering: Are we truly advancing care, or simply buying into flashy marketing?

**Beyond the Allograft**

This isn't just about nerve grafts — it's a microcosm of medicine’s broader conflict-of-interest dilemma. Without clear, standardized disclosures, clinicians risk confusing genuine breakthroughs with industry sales pitches. **Transparency isn’t optional — it’s essential.**

With love,  
P’Fella ❤️

## The Sunday Quiz

**\*Drumroll*🥁**\* New Winners Top the Leaderboard!*

****Congratulations to the Winners** of The Weekly Quiz!  
  
We're thrilled to announce the winners of this edition's quiz. After six rounds of questions on plastic surgery, our top scorers are ****Cher**, ****AL**, ****Manolo**, and ****Alexander L**.  
  
Winners, please reply to this newsletter or reach out to us!   
  
Thank you to everyone who participated and stay tuned for more fun quizzes in future editions!

![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/03/Leaderboard-Team-Post-Template--5-.png)

Leaderboard - March

Here's the rest of the leaderboard

## Image of the Week

**Clinical Insights on Vascular Tumours*

🖼️

****Image of the Week**   
  
In this section, we feature an anatomical illustration. This week’s image shows a ****rapidly growing vascular lesion** on the ****left cheek**. Infantile hemangiomas are common benign tumors, often self-resolving but sometimes requiring treatment, such as ****oral propranolol**, based on size, location, and complications.  
  
You can explore vascular tumours in detail in our [clinical case](https://www.theplasticsfella.com/vascular-tumour-clinical-case/). 

![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/03/image-2-1-1-1.png) 

#### Vascular Tumour - Clinical Case

1. Clinical diagnosis of a vascular malformation.
2. Create and justify a differential diagnosis.
3. Describe the natural history and aetiology of this condition.
4. Identify and treat complications and associated conditions.
5. Order relevant investigations.
6. Treat this condition in the short and long term.
7. Learn novel techniques and indications for surgery.

[Read the Article](https://www.theplasticsfella.com/vascular-tumour-clinical-case/) 

## Foundations Textbook

**Calling Plastic Surgery Experts!*

📙

****Plastic Surgery Student Guide Contributors**  
  
We're seeking ****plastic surgery experts** to contribute to the final review of our Plastic Surgery Student Guide. If you're interested in joining us, sign up below!

![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/03/Textbook-Design.png)

Mock Template of the Textbook

## Behind the 'Fella

**What Should We Ask Rod Rohrich?*

🎧

****Releasing Soon: Behind the 'Fella Season Two**  
  
To kick off season two of our podcast, we've invited ****Rod Rohrich** as a guest for our first episode.   
  
Got a question for him? ****Submit yours** below. 

## What Does the Evidence Say?

**What Is the Optimal Dose of Oral Propranolol?*

In this section, we dive deep into the latest research and evidence on medical practices and surgical techniques. 

Oral propranolol has emerged as an effective ****first-line** treatment for ****infantile hemangiomas** (IH). Multiple studies have demonstrated its superiority over corticosteroids, with success rates of ****60-96%** (Léauté-Labrèze et al., 2015; Andersen et al., 2014; Price et al., 2011).   
  
The recommended dosage is ****2-3 mg/kg/day**, typically administered for 6-12 months (Léauté-Labrèze et al., 2015; Solman et al., 2014). Early initiation of treatment, preferably before 5 months of age, has been associated with better outcomes (Andersen et al., 2014). Propranolol effectively ****stops IH growth**, ****reduces volume**, and ****improves color and elevation** (Hogeling et al., 2011; Sans et al., 2009). It has shown efficacy in treating various ****IH complications**, including ****vision compromise**, ****ulceration**, and ****airway obstruction** (Solman et al., 2014; Haider et al., 2010).   
  
Adverse effects are generally mild and infrequent, with no significant differences compared to placebo (Léauté-Labrèze et al., 2015; Price et al., 2011). However, ****careful monitoring** is recommended, especially during treatment initiation.

## Articles of the Week

**3 Interesting Articles with One-Sentence Summaries*

✅

****Classification, Evaluation, and Treatment of Vascular Malformations** ([Arneja](https://pubmed.ncbi.nlm.nih.gov/18349599/?ref=theplasticsfella.com), 2008)  
  
Vascular malformations differ from hemangiomas in their endothelial characteristics and require a multidisciplinary approach, with treatment strategies varying based on whether the lesion is capillary, venous, lymphatic, or arteriovenous.

✅

****ISSVA Classification for Vascular Anomalies** ([ISSVA](https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf?ref=theplasticsfella.com), 2014)  
  
The ISSVA classification distinguishes vascular anomalies into vascular tumors and vascular malformations, categorizing malformations as simple (capillary, lymphatic, venous, arteriovenous), combined, of major named vessels, or associated with other anomalies.

✅

****Mulliken and Glowacki’s Landmark Classification of Hemangiomas and Vascular Malformations** ([Mulliken](https://pubmed.ncbi.nlm.nih.gov/7063565/?ref=theplasticsfella.com), 1982)  
  
Mulliken and Glowacki's 1982 classification distinguishes hemangiomas, which exhibit endothelial proliferation and spontaneous regression, from vascular malformations, which are present at birth, grow proportionally, and lack proliferative endothelial activity.

## Feedback

### I hope you enjoyed it 😄

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