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Pilonidal Disease and Hidradenitis Suppurativa

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The ASCRS Textbook of Colon and Rectal Surgery

Abstract

“Pilonidal disease” refers to a subcutaneous infection occurring in the upper half of the gluteal cleft. It may present as an acute “pilonidal abscess,” or as an indolent wound, resistant to spontaneous healing, and causing drainage and discomfort. It typically presents in the second decade of life, but also occurs in teenagers and in patients in their thirties.1 It afflicts men more often than women at a ratio of three or four to one, and is more common in individuals with more body hair.1 It is not known to be more common in any one racial group. During World War II, soldiers filled up whole hospital wards to convalesce from the large excisional operations used at the time to treat pilonidal disease.2 It became such a problem that the Surgeon General forbade wide local excision as primary therapy, because this treatment had hospitalized 79,000 soldiers for an average hospital stay of 55 days.3 Akinci et al.4 reported an 8.8% incidence of pilonidal disease in Turkish Army recruits and found associations with family history, obesity, being a vehicle driver, and having a history of a furuncle at another site on the body. Sondenaa et al. studied 322 patients with pilonidal disease prospectively and calculated the incidence of the disease at 26 per 100,000 persons. It occurred 2.2 times more often in men than in women. He also found the following significant associations: family history in 38%; obesity in 37%; preceding local irritation or trauma in 34%; and a sedentary occupation in 44%. Since World War II, a paradigm shift has occurred in favor of conservative measures, mainly in the form of shaving and hygiene.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

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Authors
  1. Jeffery M. Nelson
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  2. Richard P. Billingham
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Editor information

Editors and Affiliations

  1. Professor of Surgery, Mayo Clinic College of Medicine, Chairman, Division of Colon and Rectal Surgery, Mayo Clinic Foundation, Rochester, MN, USA

    Bruce G. Wolff MD, FASCRS (Senior Editors) (Senior Editors)

  2. Professor of Surgery, Chief, Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, MO, USA

    James W. Fleshman MD, FASCRS (Senior Editors) (Senior Editors)

  3. Chairman, Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA

    David E. Beck MD, FASCRS (Senior Editors) (Senior Editors)

  4. Professor of Surgery, Mayo Clinic College of Medicine, Consultant, Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA

    John H. Pemberton MD, FASCRS (Senior Editors) (Senior Editors)

  5. Chief of Staff, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD, FASCRS (Senior Editors) (Senior Editors)

  6. Victor W. Fazio Chair of Colorectal Surgery, Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA

    James M. Church BSc, MBChB, MMed Sci, FASCRS (Associate Editors) (Associate Editors)

  7. Professor of Surgery, Chief, Section of Colon and Rectal Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Julio Garcia-Aguilar MD, PhD, FASCRS (Associate Editors) (Associate Editors)

  8. Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, MA, USA

    Patricia L. Roberts MD, FASCRS (Associate Editors) (Associate Editors)

  9. Professor of Surgery, Head, Section of Colon and Rectal Surgery, Rush University Medical Center, Chicago, IL, USA

    Theodore J. Saclarides MD, FASCRS (Associate Editors) (Associate Editors)

  10. Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA

    Michael J. Stamos MD, FASCRS (Associate Editors) (Associate Editors)

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Nelson, J.M., Billingham, R.P. (2007). Pilonidal Disease and Hidradenitis Suppurativa. In: Wolff, B.G., et al. The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-36374-5_15

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  • DOI: https://doi.org/10.1007/978-0-387-36374-5_15

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-24846-2

  • Online ISBN: 978-0-387-36374-5

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