Abstract
Background
Recent studies have identified various socioeconomic disparities in postoperative outcomes among adults undergoing head and neck (H&N) microsurgical reconstruction. This study aimed to measure the impact of socioeconomic factors on outcomes of H&N free tissue transfer in a pediatric population.
Methods
A retrospective review was conducted of children who underwent H&N free tissue transfer (FTT) at a tertiary children’s hospital between 2007 and 2024. Socioeconomic status was quantified using Area Deprivation Index (ADI), a composite measure of disadvantage reported across ZIP codes. Patient health records were reviewed for postoperative flap outcomes, which were compared across ADI cohorts.
Results
A total of 59 patients, undergoing 75 FTTs, met inclusion criteria, among whom 43.1% were considered low deprivation and 56.9% high deprivation. Overall flap survival was 97.3%. Rates of flap failure, unanticipated revision, and readmission did not differ between cohorts. However, flap dehiscence was significantly more likely among high deprivation patients (25.6% vs 6.2%, P = 0.034). Furthermore, every 1 point increase in ADI over 5 was associated with a 7.8% increase in the odds of flap dehiscence (P < 0.05).
Discussion
Neighborhood socioeconomic deprivation was independently predictive of flap dehiscence among children undergoing H&N FTT, but was not associated with flap failure, flap revisions, or 30-day readmissions. This finding underscores the broader impact of socioeconomic factors on pediatric health outcomes, particularly surgical wound healing.
Keywords
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Supplementary Material
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