Page 125 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Table 4:
Comparison of screening tool items of the patients who wanted BCS and qualify for referral and reimbursement (n=25) and the patients who want BCS and do not qualify (n=71), presented as mean ± standard deviation or percentage (n).
Parameter p-value Current %TWL 0.014
Qualify
Does not qualify
28.1 ± 10.1 29.1 ± 5.6 25 (100%) 3.4 ± 1.7 22 (88%) 24 (96%)
33.5 ± 6.2 31.4 ± 5.2 51 (72%) 2.2 ± 1.6 43 (61%) 60 (85%)
Current BMI, kg/m2
Stable weight > 12 months
Medical score
Psychological issues
Functional issues 0.123 TWL = total weight loss; BMI = Body Mass Index.
Qualification and BODY-Q
Patients who qualified scored lower on all BODY-Q scales. There was a significant difference on the appraisal of excess skin scale: mean score was 29.9 in patients who qualified and 44.1 in the patients who did not (p=0.011).
DISCUSSION
Reimbursement of body contouring procedures is a worldwide issue, because there is no instrument available to objectively select which patients should qualify for re- imbursement. Therefore, the goal of this study was to assess a modified version of the BAPRAS screeningtool. This is the first screening tool developed to decide which patients qualify for reimbursement, based on a broad array of parameters.
Our study clearly demonstrated that patients who want BCS have a significantly high- er score on the screening tool compared to patients who do not want BCS. These patients had a stable weight, higher weight loss (%TWL), lower current BMI and more medical and psychological complaints compared to patients who did not qualify for referral. The screeningtool scores significantly correlated with almost all BODY scales, showing that these ‘simple’ questions reflect the impact of complaints on patients. Thus, our modified BAPRAS screening tool selects the patients who have the best weight loss results and are most impacted by excess skin in their daily lives.
A large part of the study population wanted BCS and had a wide range of problems caused by the excess skin 13,15,28-30. These patients were mostly bothered by excess skin on the abdomen, breasts/chest and inner thighs 13,31. Medical issues like intertrigo (68.3%), hidradenitis (31.7%) and dermatitis (55.8%) were frequently reported 13,32. In addition, many patients had functional complaints of their excess skin (78.3%), such as hindrance in daily activities and sporting 32-34. And almost 60% of our population suffered from psychological issues, such as depressive feelings and shame, which is in concordance with the low scores on the BODY-Q 13,35,36. This aspect clearly demon- strates that overhanging skin significantly negatively influences patients’ well-being.
0.062 0.011 0.002 0.009
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