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Quick Calculation of Breast Resection Weight Using the Schnur Scale
Lucas Dvoracek, John Pang, Jeffrey Gusenoff, J. Peter Rubin, Ernest Manders
University of Pittsburgh
2017-02-13
Presenter: Lucas Dvoracek
Affidavit:
All of the work on this project is original and was performed by the resident.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
In 1991 Dr. Paul Schnur and his colleagues published a paper suggesting the weight of breast tissue to be removed in a breast reduction operation based on the total body surface area of the patient. They presented a very cogent argument for selecting three groups of patients: those with medical indications for operation, those who merit review, and those whose operation could be considered cosmetic. The Schnur scale is widely used by insurance companies in the western US in the process of preauthorizing breast reduction operations. Its use may be spreading eastward.
The Schnur group presented a nomogram for calculating body surface area and a scale in the form of a table for guiding a determination of whether the patient is clearly a reconstructive patient as opposed to an aesthetic patient. Here we have combined the scale and the BSA nomogram for a simplified nomogram calculator that facilitates rapid determination of anticipated tissue weight of resection for a patient of a given size. This calculator gives the weight of tissue to remove with just knowledge of the patient's height and weight and a straight edge. This weight is meant to help counsel the patient prior to planning surgery.
We will review the reasoning behind the development of the Schnur scale, the limitations that they acknowledged, and its use today. Demonstration of use of the calculator tool will be included.
