Referral to emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- nil
For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Exclusions
Central Adelaide Local Health Network (CALHN):
- body mass index (BMI) greater than or equal to 35
- active smokers/vapers
Triage categories
Category 1 - appointment clinically indicated within 30 days
- nil
Category 2 — appointment clinically indicated within 90 days
- nil
Category 3 — appointment clinically indicated within 365 days
- abdominoplasty following massive weight loss
- abdominoplasty for rectus diastasis (divarication)
For more on outpatient referrals, see the general referral information.
Essential referral information
Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
- identifies as Aboriginal and/or Torres Strait Islander
- relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- past medical/surgical history including bariatric surgery date and outcomes
- current medications and dosages
- allergies and sensitivities
- smoking/vaping status
- presenting symptoms
- management history including:
- associated features e.g. functional impairment, severe intractable intertrigo
- onset and duration
- pain/discomfort
- severity of symptoms
- impact on activities of daily living
- treatments trialled/implemented prior to referral
- maintained stable weight (less than 5 kilograms variation) for greater than 6 months
- massive weight loss surgery:
- bariatric surgery patients must be 18 months post-operative after their latest bariatric procedure
- divarication:
- 3cm diastasis recti confirmed on ultrasound
- allied health reports for treatment of diastasis recti
- date of last pregnancy must be greater than 12 months
Additional information to assist triage categorisation
Additional referral criteria for Central Adelaide Local Health Network (CALHN):
Clinical management advice
Patients with body mass index (BMI) greater than or equal to 35 should be counselled around weight loss management. Please refer to useful resources section for further information.
Abdominoplasty for patients who have had significant weight loss may be offered in the following circumstances:
- the circumferential excess of redundant skin and fat is complicated by a skin condition that risks loss of skin integrity and has failed 3 months of non-surgical treatment; and
- the circumferential excess of redundant skin and fat interferes with the activities of daily living; and
- the patient’s weight has been stable for at least 6 months following significant weight loss - at least 5 BMI points - prior to the lipectomy.
Abdominoplasty associated with correction of diastasis of rectus abdominus muscle may be offered to patients in the following circumstances:
- has a diastasis of at least 3cm divarication confirmed on ultrasound; and
- has symptoms of pain or discomfort at the diastasis site during functional use and/or low back pain or urinary symptoms likely due to rectus diastasis; and
- has failed to respond to non-surgical treatment including physiotherapy; and
- has not been pregnant in the last 12 months with no further plans for further pregnancies
It is strongly recommended that people who smoke or vape stop at least 3 months prior to surgery. Smoking/vaping is associated with delayed skin healing. Please refer to useful resources section for further information.