{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:41:07Z","timestamp":1777448467958,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent studies have identified various socioeconomic disparities in postoperative outcomes among adults undergoing head and neck (H&amp;N) microsurgical reconstruction. This study aimed to measure the impact of socioeconomic factors on outcomes of H&amp;N free tissue transfer in a pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of children who underwent H&amp;N free tissue transfer (FTT) at a tertiary children\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.034). Furthermore, every 1 point increase in ADI over 5 was associated with a 7.8% increase in the odds of flap dehiscence (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Neighborhood socioeconomic deprivation was independently predictive of flap dehiscence among children undergoing H&amp;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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251351006","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T11:57:06Z","timestamp":1749643026000},"page":"1677-1683","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neighborhood Socioeconomic Deprivation Predicts Poor Wound Healing Following Head and Neck Free Tissue Transfer in Children"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8826-3184","authenticated-orcid":false,"given":"Asli","family":"Pekcan","sequence":"first","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-9781","authenticated-orcid":false,"given":"Melanie","family":"Bakovic","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Mejia","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7220-8102","authenticated-orcid":false,"given":"Raina K.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvee","family":"Turk","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Naidu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark M.","family":"Urata","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"},{"name":"Division of Oral and Maxillofacial Surgery, Keck School of Medicine, Los Angeles, CA, USA"},{"name":"Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Hammoudeh","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"},{"name":"Division of Oral and Maxillofacial Surgery, Keck School of Medicine, Los Angeles, CA, USA"},{"name":"Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1776698"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009325"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003869"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.953"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000006035"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656231226070"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"e_1_3_6_9_2","volume-title":"Income in the United States: 2023","author":"Bureau UC","unstructured":"Bureau UC. 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