EP610 - Determining a Correlation Between Season and Pilonidal Incidence

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Purpose/Background: Pilonidal disease has multiple known risk factors, including obesity, male sex, age, lifestyle (prolonged sitting), an increased amount of hair near the gluteal cleft, and stiffer hair near the gluteal cleft. Multiple studies have determined these patient-specific risk factors play in the development of pilonidal disease, but to the best of our knowledge, there is no research examining the role that environmental factors—particularly, ambient temperature and season—contribute. Existing studies demonstrate a correlation between family history of pilonidal disease, local trauma, a sedentary occupation, obesity, and the development of pilonidal disease. Moreover, there is a strong correlation between hidradenitis suppurativa and pilonidal sinus disease, and ER visits in patients with HS exhibits a seasonal trend, with ER visits greatest during the summer months. We propose a retrospective study of patients previously seen in the office for pilonidal disease to determine if there is a similarly increased incidence of disease during warmer times of the year.

Methods/Interventions: A retrospective review of charts was performed to determine rate of pilonidal disease requiring incision and drainage throughout the year. Patients were selected by CPT code (10080-10081, incision and drainage of pilonidal cyst), with manual chart review performed to ensure accuracy of data. All patients seen at any of five office locations in a large metropolitan area were eligible for inclusion in the study. The expected/ baseline rate was defined as an even distribution of procedures throughout the year. A chi-squared analysis was performed to examine whether the rate of pilonidal cysts requiring incision and drainage was significantly higher than expected.

Results/Outcomes: 225 patients were included in this study, with 119 men and 106 women included. Average BMI of the group was 30.2. A chi-squared analysis demonstrated no statistically significant increase in pilonidal disease during warmer months (p=0.78).

Conclusion/Discussion: The incidence of pilonidal abscesses is evenly distributed throughout the year and does not exhibit any seasonality or peak in warmer weather. This distinguishes it from HS which exhibits a peak during warmer months. However, there are some limitations to this study. We examined only pilonidal disease which was severe enough to warrant in-office incision and drainage; this excludes patients undergoing conservative management and those with pilonidal disease that is successfully treated in a non-specialist setting (such as in the ER or urgent care). As pilonidal disease predominantly affects younger patients, there may be some effect from the academic calendar in the data, with more procedures done when patients are home from school, although this was not demonstrated in our data.