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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