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Reconstructive Surgery

Referral Acceptance

Plastic Surgery referrals are prioritised by Senior Medical Officers based on the information contained within. Additional information should be attached where available. The priorisation tool used to triage referrals can be found below under Access Criteria.

All skin lesions referred from the PHO will be accepted at Tauranga Hospital.

All accepted referrals will be seen within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Referral acceptance is a follows:

First Specialist Assessments Wait Times

Waiting priority 1

Accepted

Waiting priority 2A

Accepted

Waiting priority 2B

Declined

Waiting priority 2C

Accepted

Waiting priority 3

Declined


At First Specialist Assessment (FSA), patients are assessed by a specialist and if surgery is required, patients are then prioritised using the National Plastic CPAC tool.  A 0-100 score is allocated to each patient.

Prior to acceptance for surgery, patients are assessed in Anaesthetic preassessment clinic to ensure they are fit for surgery.

All patients accepted for surgery will be treated within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Surgery acceptance is as follows:

Treatment List
Plastic surgery CPAC 10+ Accepted
Plastic surgery hand and upper limb CPAC 58+ Accepted
Skin lesions CPAC 30+ Accepted

National Access Criteria for First Assessment (ACA)

Bay of Plenty Variation

Category Criteria

Immediate

Priority 1

  • Melanoma or melanoma in situ – or suspected

  • T2 (2cm or larger) Squamous Cell Carcinoma

  • Malignancies – head/neck/oral/salivary/connective tissue/sarcoma/lymph node

  • Facial palsy – if risk of corneal exposure

  • Vascular malformations if encroachment on visual field

Urgent

Priority 2A

  • T1 squamous cell carcinoma of skin

  • Basal cell carcinoma

  • Primary Breast Reconstruction

  • Reconstruction after tissue loss with functional impairment (G3 with no func imp)

Semi Urgent

Priority 2B

  • Chronic sores and ulcers/Pressure sores
  • Carpal Tunnel and other nerve compression syndromes

  • Facial palsy

  • Nerve palsies

  • Congenital hand deformities with functional impairment (G3 with no func imp)

  • Dupuytrens contracture with functional impairment (G3 with no func imp)

  • Stenosing tenosynovitis (eg de Quervains)

  • Vascular malformations

  • Hydradenitis suppurativa

Semi Urgent

Priority 2C

  •  Secondary Breast reconstruction

Routine

Priority 3

  • Benign skin lesions and subcut lumps

  • Benign tumors

  • Scar revision and scar management

  • Liposuction in “abnormal” cases

  • Abdominal redundancy

  • Maxillo-facial deformities

  • Nasal deformity/reconstruction

  • Rhinophyma

  • Ptosis (levator weakness)

  • Ectropion

  • Eyelid reduction in “abnormal” cases

  • Ear reconstruction (congenital and traumatic abnormalities)

  • Prominent ears

  • Breast reduction

  • Mastopexy

  • Gynaecomastia

  • Congenital abnormalities of the breast

  • Chest wall deformities (eg pectus excavatum)

  • Ganglion and soft tissue tumors of the hand


BOPDHB has limited plastic surgery specialist FTE. ACC related injuries can be referred to the DHB, but depending on priority may wait longer than referral to a private provider.

The following conditions are not seen locally, but referred to Waikato for tertiary management:

  • Cleft Lip and Palate
  • Vaginal/Vulval/Penile reconstruction
  • Neonate congenital hand deformities
  • Neonate Hypospadias/Epispadias
  • Burns and burn scar management
  • Craniofacial abnormalities