BackgroundRecent 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.MethodsA 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.ResultsA 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).DiscussionNeighborhood 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: area deprivation index; free flap; free tissue transfer; head and neck reconstruction; neighborhood deprivation; pediatric microsurgical reconstruction; socioeconomic disadvantage.

背景：最近的研究发现，接受头颈部（H&N）显微外科重建的成人患者在术后结果方面存在各种社会经济差异。本研究旨在测量社会经济因素对儿童头颈部游离组织移植（FTT）结果的影响。
方法：回顾性分析了2007年至2024年间在一所三级儿科医院接受H&N游离组织移植手术的儿童患者的数据。使用区域剥夺指数（ADI），一个在邮政编码区域内报告的社会劣势综合衡量指标，量化社会经济地位。审查患者的健康记录以获取术后皮瓣结果，并将其与不同ADI组进行比较。
结果：共有59名患者进行了75次游离组织移植手术，其中43.1%的患者被认为是低剥夺程度，而56.9%的患者是高剥夺程度。总体皮瓣存活率为97.3%。各组之间的皮瓣失败率、意外修订和再住院率没有差异。然而，在高剥夺程度的患者中皮瓣裂开的发生率显著更高（25.6% vs 6.2%，P = 0.034）。此外，每增加1个ADI点（超过5），发生皮瓣裂开的可能性增加了7.8%（P 讨论：社区社会经济剥夺程度独立预测了接受头颈部游离组织移植手术的儿童患者中皮瓣裂开的发生情况，但与皮瓣失败、皮瓣修订或30天内再住院无关。这一发现强调了社会经济因素对儿科健康结果更广泛的影响，特别是在术后伤口愈合方面。

关键词：区域剥夺指数；游离皮瓣；游离组织移植；头颈部重建；社区剥夺；儿童显微外科重建；社会经济劣势