REFERRAL GUIDELINES PLASTIC SURGERY

Transcription

1 REFERRAL GUIDELINES PLASTIC SURGERY Referral Form: The GP Referral Template is the preferred referral tool (previously known as the Victorian Statewide Referral Form) GP Referral Template This tool is housed in most major clinical software or can be downloaded from Click on category to advance to that page: Abdomen Genital Abdominoplasty Vaginal/Penile reconstruction following malignancy Breast Hand Reconstruction following mastectomy Open hand fracture Reduction mammoplasty Closed hand fracture Augmentation mammoplasty Acute fingertip injuries Gynaecomastia Sub-acute fingertip injuries Congenital abnormalities Congenital deformities Mastoplexy Secondary hand surgery after injury Removal of prosthesis Stenosing tenosynovitis Carpal tunnel & other nerve compression syndromes Ear Nerve palsies Reconstruction (Congenital & traumatic Rheumatoid hand deformities abnormalities) Dupuytrens contracture Eyelid Ganglia Ptosis Ectropion Lesions Eyelid reduction in abnormal cases Melanoma Other skin cancers Malignancies including head, neck, Face salivary gland, connective tissue Craniofacial abnormalities Benign skin lesions Faciomaxillary abnormalities Subcutaneous & deep tissue tumors General Nose Scar revision and scar management Nasal deformity due to trauma Pressure sores Nasal reconstruction Vascular malformations Rhinophyma Other chronic sores and ulcers Foreign Body removal Sarcoma Burns and scars Suspected Primary Bone Tumour Lymphoedema Suspected Soft Tissue Sarcomas (limb/trunk) Suspected Soft Tissue Sarcomas at non limb/trunk sites Helpful information **Guidelines for Aesthetic Surgery on the Public Hospital Waiting List** PLEASE NOTE: All referrals received by Monash Health are triaged by clinicians to determine urgency of referral. Patients assessed as having an urgent need are offered an appointment within thirty days as assessed by the clinician. Patients assessed as having a non-urgent need for appointments in clinics where there is no waiting list, are offered an appointment within four months on a treat in turn basis. Patients assessed as having a non-urgent need for appointments in clinics that have a waiting list, referrers and patients will be notified of the expected wait times. Where the wait time does not meet patient needs, alternative service providers can be found by searching the Human Services Directory at IMPORTANT: The following information is mandatory: Demographics: Full name Date of birth Postal address Landline & mobile number Medicare number Referring GP details Usual GP (if different) Interpreter requirements Clinical: Reason for referral Duration of symptoms Management to date and response to treatment Past medical history Current medications and medication history if relevant Functional status Psychosocial history Dietary status Family history Diagnostics as per referral guideline HEAD OF UNIT A/Prof James Leong (Dandenong) Mr David Ross (Clayton) PROGRAM DIRECTOR Mr Alan Saunder ENQUIRIES (Outpatient Access) P: F: (03) Review Jul

2 Abdomen Abdominoplasty History: Standard history Cessation of smoking Weight reduction BMI Breast Reconstruction following Mastectomy Reduction Mammoplasty Body Mass Index When there are significant symptoms or recurrent interrigo. See guidelines for Aesthetic Surgery on the Public Hospital Waiting List July 2012 (see link on front page) Augmentation Mammoplasty Body Mass Index Post mastectomy reconstruction, augmentation for contralateral breast - polans syndrome or post burn reconstruction Gynaeomastia Congenital abnormalities Mastoplexy Body Mass Index Following significant weight loss eg. After gastric banding or for correction of significant breast reconstruction. Removal of prosthesis Body Mass Index If rupture of silicone prosthesis 2

3 Ear Reconstruction for traumatic and congenital abnormalities If secondary to acute trauma Eyelid Ptosis Ectropion Eyelid reduction in abnormal cases N/a If causing obstruction of vision otherwise do not refer Face Craniofacial abnormalities Faciomaxillary abnormalities N/a Refer to Faciomaxillary Clinic 3

4 General Scar revision and scar management Vascular malformations Investigation: USS of lesions Pressure sores Contact plastic surgery clinic coordinator to discuss assessment of non-ambulant patients Other chronic sores and ulcers Foreign body removal X-Ray or USS as appropriate Burns and burn scars Lymphoedema 4

5 Genital Vaginal/Penile reconstruction post malignancy Hand Open fractures Closed hand fractures Acute fingertip injuries Refer to ED for assessment Hand X-ray Sub-acute fingertip injuries Refer to Outpatients urgently Congenital deformities Secondary hand surgery after injury Hand X-ray Stenosing tenosynovitis History: Hand USS Carpel tunnel and other nerve compression syndromes Nerve conduction studies Nerve palsies Nerve conduction studies Rheumatoid hand deformities History: Hand USS Dupytrens contracture History: Ganglia, Soft tissue tumors of the hand History: USS of lesion 5

6 Lesions Melanoma, confirmed or suspected Do not perform punch biopsy if Melanoma is suspected Pathology report if available Other skin cancers Include details of site and size of excision required Refer for definitive diagnosis Malignancies including: Head Neck Oral Salivary glands Connective tissue Refer to Outpatients urgently CT Scan and other imaging as appropriate Benign skin lesions Biopsy Subcutaneous and deep tissue tumors USS of lesion CT scan if malignancy suspected Nose Nasal deformity due to trauma Refer to Outpatients urgently or to the ED if severe Nasal reconstruction X-Ray Refer immediately if post fracture See Guidelines for Aesthetic Surgery on the Public Hospital Waiting List July 2012 Rhinophyma - immediate/trauma 6

7 Sarcoma Suspected Primary Bone Tumour X-ray Suspected Soft Tissue Sarcomas (limb/trunk) X-ray Suspected Soft Tissue Sarcomas at non limb/trunk sites Refer to Outpatients urgently X-ray 7