Plastic and Reconstructive Surgery  |  Elective Services




Plastic and Reconstructive Surgery

Elective Services

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

Skins Accepted

Waiting priority 2B

Declined

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

Waiting CPAC 60+

Accepted

Waiting CPAC <60

Declined

 

Access Criteria:

Category

Criteria

Referral Guidelines

1 -  Immediate

Lesions

  • Melanoma - or suspected
  • Other malignancies - hand/neck/oral/salivary
  • Other malignancies - connective tissue

 

  • Incision biopsy not recommended

General

  • Reconstructive after tissue loss
  • Burns and burn scar management
  • Pressure sores

  

Face

  • Cleft lip and palate

 

2 -  Urgent

Lesions

  • Other skin cancers (not MM) or suspected

  

General

  • Vascular malformations
  • Pressure sores
  • Other chronic sores and ulcers
  • Hydradenitis suppurativa
  • Foreign body removal

 

  • Cat. 1 if encroachment on visual field

Face

  • Other craniofacial abnormalities
  • Maxillo facial abnormalities, especially cleft lip and palate
  • Facial Palsy




 
  • Cat. 1 if risk of corneal exposure

Eye Lids

  • Ptosis (levator weakness)
  • Extropion
  • Eyelid reduction in 'abnormal' cases

  

Breast

 

Hands

  • Secondary hand surgery after injury
  • Stenosing tenosynovitis (eg de Quervains)
  • Carpal tunnel and other nerve compression syndromes
  • Nerve Palsies
  • Rheumatoid Hand deformities
  • Dupuytrens contracture
  • Ganglion and soft tissue tumours of the hand

 

3 - Routine

Lesions

  • Benign skin lesions and sub cut lumps
  • Benign tumours other than skin and sub cut

 

General

  • Reconstruction after tissue loss
  • Scar revision and scar management
  • Burns and burn scar management
  • Vascular malformations
  • Other chronic sores and ulcers
  • Hydradenitis suppurativa
  • Axillary hyperhidrosis
  • Foreign body removal
  • Lymphoedema
  • Chest wall deformities (eg pectus excavatum)
  • Liposuction in 'abnormal' cases
  • Abnormal redundancy

 

 

  • Cat. 1 if encroachment on visual field
  • Local service to indicate availability

Face

  • Maxillo facial abnormalities, especially cleft lip and palate
  • Facial palsy
  • Tongue reduction
  • Tongue tie




  • Cat. 1 if risk of corneal exposure
  • Downs syndrome
  • Refer if affecting speech

Nose

  • Nasal deformity
  • Nasal reconstruction
  • Rhinophyma

 

Eye Lids

  • Ptosis (levator weakness)
  • Ectropion
  • Eyelid reduction in 'abnormal' cases

 

Ears

  • Ear reconstruction (congenital and traumatic abnormalities)
  • Prominent ears

 

  • Indicate whether hearing status has been checked
     
  • Local service to indicate availability

Breast

  • Breast reduction
  • Gynaecomastia
  • Mastopexy
  • Congenital abnormalities of the breast

 

  • Local service to indicate availability

Hands

  • Congenital hand deformities
  • Secondary hand surgery after injury
  • Nerve Palsies
  • Rheumatoid hand deformities

 

  • Cat. 1 if neonate or antenatal

Genital

  • Hypospadia/Espispadias
  • Vaginal/Vulval/Penile reconstruction

 

  • Cat. 1 if neonate. Has renal track been imaged?

ACC

General

  • Burns and burn scar management
  • Foreign body removal
  • Ear reconstruction (congenital and traumatic abnormalities)




  • Indicate whether hearing status has been checked


Last updated : Tuesday, March 14, 2017
Next review date : Wednesday, March 14,2018


Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.