title: Pilonidal Sinus Disease: A 10-Year Review Reveals Occupational Risk Factors and the Superiority of the Minimal Surgery Trephine Technique.
abstract: OBJECTIVE
  To identify military occupational risk factors for pilonidal sinus disease (PSD) and to compare an Army Clinic minimal surgery with techniques used at public hospitals.
  
  
  METHODS
  Review of a historical cohort of soldiers (3,407 with PSD) to determine PSD risk factors in military personnel and comparison of postoperative sick leave days between surgical techniques.
  
  
  RESULTS
  Male and female officers had a lower PSD incidence, whereas male combatants and female drivers were at higher risk compared to administrative personnel. The minimal surgery technique used at the Army Clinic was associated with an average 13 less postoperative sick leave days per patient, as compared to the surgical techniques including wide excision used at public hospitals. Compared to healthy soldiers, the relative risk for PSD recurrence was 7.87 in all males and 9.54 in male combatants.
  
  
  CONCLUSIONS
  Male combatants and female drivers are at higher risk for PSD, whereas officers and administrative personnel are at lower risk. Compared with surgical techniques used at public hospitals, the Army Clinic exclusive use of the Gips minimal surgery technique is associated with fewer sick leave days. Prior surgery for PSD is a positive predictor of recurrence, and these patients warrant secondary prevention.
authors.affiliation: Department of Internal Medicine E, Tel Aviv Medical Center, Tel Aviv, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Levinson
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Sela
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Chencinski
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Estela
authors.initials: E
authors.lastname: Derazne
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Dorit
authors.initials: D
authors.lastname: Tzur
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Hadar
authors.initials: H
authors.lastname: Elad
authors.affiliation: Medical Corps, Israel Defense Forces, Tel Hashomer Base, Tel Hashomer 52620, Israel.
authors.forename: Yitshak
authors.initials: Y
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel; D019060:Minimally Invasive Surgical Procedures; D009784:Occupational Diseases / Q000453:epidemiology* / Q000601:surgery; D010864:Pilonidal Sinus / Q000453:epidemiology* / Q000601:surgery; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome