Pilonidal disease in a military population: how far have we really come?
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.
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
Emilie B
EB
Fitzpatrick
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
Patrick M
PM
Chesley
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
Morohunranti O
MO
Oguntoye
Department of Surgery, UMass Memorial Medical Center, Worcester, MA, USA.
Justin A
JA
Maykel
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
Eric K
EK
Johnson
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA. Electronic address: harkersteele@mac.com.
Scott R
SR
Steele
D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D010864:Pilonidal Sinus / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014861:Washington; D055815:Young Adult
Complications; Military; Pilonidal abscess; Pilonidal cyst; Pilonidal disease; Recurrence