Pilonidal disease in a military population: how far have we really come?

Am J Surg. 2014 Jun;207(6):907-14. doi: 10.1016/j.amjsurg.2013.07.038. Epub 2013 Oct 26.

Abstract

Background: Pilonidal disease (PD) has a long connection with military personnel, even nicknamed "jeep disease" during World War II. The aim of this study was to identify factors associated with recurrence and complications after surgery in a military population.

Methods: A retrospective cohort analysis of operative therapy for PD at a single institution from 2005 to 2011 was conducted. Patient demographics, disease characteristics, and surgical methods were assessed for the primary outcomes of recurrence and morbidity.

Results: A total of 151 patients with PD were identified, who underwent excision (45.7%), excision with primary closure (29.8%), and incision and drainage (9.9%). Overall recurrence and morbidity rates were 27.2% and 34.4%, respectively. Black race, chronic disease, wound infection, and infection and drainage were associated with recurrence (P < .05), and excision with primary closure was associated with increased complications (P < .001).

Conclusions: PD remains a significant source of morbidity and recurrence among military personnel. Certain patient-related and disease-related factors portend a worse prognosis, with black race and operative method the strongest predictors of outcomes.

Keywords: Complications; Military; Pilonidal abscess; Pilonidal cyst; Pilonidal disease; Recurrence.

MeSH terms

  • Drainage
  • Female
  • Humans
  • Male
  • Military Personnel*
  • Pilonidal Sinus / surgery*
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Washington
  • Young Adult