Page 133 - When surgery alone won’t cut it - Valerie Maureen Monpellier
P. 133
Chapter 7
Appendix 2: The Dutch ReBoc tool: a new screening tool for referral and possible reimbursement of post-bariatric body contouring surgery.
STEP 1: CHECK CRITERIA
Criteria for referral, the patient:
1. Is at least 18 months after bariatric surgery.
2. Has a stable weight for at least 12 months.
3. Has a BMI < 35 kg/m2 (except when BMI before bariatric surgery was
>50kg/m2)
4. Has no recent life-events, psychological/psychiatric issues and/or drug
use. If so, patient should have a consultation at the psychologist to
decide whether there is a contra-indication for BCS.
5. Was not recently pregnant (<12 months ago) or has desire for children in
the near future.
STEP 2: CALCULATE SCORE
Total Body Weight loss
<20%
0
20-39%
1
>39%
2
Current BMI
>30 kg/m2
-1
27-30 kg/m2
0
26-27 kg/m2
1
≤25 kg/m2
2
Skin condition caused by excess skin (1 point for each condition*)
No
0
Yes
1 to 6
Functional complaints caused by excess skin
No
0
Yes
1
Psychological complaints caused by excess skin
No
0
Yes
1
Smoking
Never
1
Quit
0
<2/day
-1
<5/day
-2
5-10/day
-3
11-20/day
-4
21-40/day
-5
>40/day
-10
TOTAL SCORE
* dermatitis, hidradenitis, Intertrigo, infection, lymph oedema, ulceration
STEP 3: SCORE ≥ 8: REFERRAL TO PLASTIC SURGEON
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