Social Determinants of Health in Patients Undergoing Osteocutaneous Free Flap Reconstruction for Malignant Disease of the Mandible

BACKGROUND: Social determinants of health (SDH), such as race, language, and insurance status, may impact access to surgical care and postoperative outcomes. This study investigates the role of SDH in patients undergoing osteocutaneous free flap reconstruction for mandibular defects due to oral cavity malignancy. METHODS: A retrospective cohort study of 131 patients at a single tertiary academic center was conducted. Demographic variables and clinical outcomes were extracted from records. The CDC Social Vulnerability Index (SVI) assessed county-level SDH. Outcomes included readmission, reoperation, flap failure, tracheostomy outcomes, and complications. RESULTS: No significant differences were observed in clinical outcomes based on race, language, or insurance status. The only significant difference was travel distance, with non-minoritized patients traveling farther (84.7 vs. 44.2 miles, p = 0.013). SDH metrics did not influence surgical timing or complications. CONCLUSIONS: In a well-supported care setting, equitable access to complex reconstructive surgery may reduce disparities associated with SDH.