Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

Abstract

PURPOSESacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease.METHODPreviously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients.RESULTSStiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001). With an adjusted odds ratio of 1.3 (p<.001), body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease.CONCLUSIONSHairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

Evaluation of the risk factors of pilonidal sinus: A single center experience

“…Recent studies reported comparable findings and showed that patients who bathed two times or less per week were at risk for PS (5). Increasing body hair rate was associated with a higher risk of developing PS in previous studies (6).…”

Treatment of pilonidal disease by phenol application

“…None of the publications related to phenolization has considered this issue when selecting patients. Similarly, obesity has been reported as a risk factor in patients with PD (33,35). This particular patient group with deep intergluteal sulcus or obesity might not benefit from phenol application.…”

“…Duration of the phenol in the sinus tract is an important factor for success of the application. Many studies have reported the duration of phenol in the sinus as approximately 2-8 min (20,27,31,33). However, in one study, it has been reported that protein structure of the hair was destructed at least 9 min after phenolization (23).…”

“…In some studies, patients have been followed-up each week periodically (19,31,33). More frequent follow-up schedules have been reported as 1, 3, 5, 7, 15 days after the operation (16).…”

Nd:YAG Laser (1064 nm) in Management of Pilonidal Sinus

“…They found that family history; obesity; being the driver of a vehicle; and having folliculitis or a furuncle can be associated with the presence of PNS (22). Harlak et al have suggested that hairy people who sit down for more than six hours a day and those who take a bath two or less times per week have an increased risk for PNS than those without these risk factors (23).…”