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Pilonidal disease in a military population: how far have we really come?
Emilie B Fitzpatrick1, Patrick M Chesley1, Morohunranti O Oguntoye1
1Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
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.
