Strength of Occipital Hair as an Explanation for Pilonidal Sinus Disease Caused by Intruding Hair.

Doll, Dietrich; Bosche, Friederike D; Stauffer, Verena K; Sinicina, Inga; Hoffmann, Sebastian; van der Zypen, Dominic; Lüdi, Markus (2017). Strength of Occipital Hair as an Explanation for Pilonidal Sinus Disease Caused by Intruding Hair. Diseases of the colon and rectum, 60(9), pp. 979-986. Lippincott Williams & Wilkins 10.1097/DCR.0000000000000795

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BACKGROUND Pilonidal sinus disease is thought to be caused by intrusion of hair into healthy skin; loose hair in the intergluteal fold is thought to promote disease. However, compelling evidence to support these postulates is lacking; the cause of pilonidal sinus disease remains uncertain. OBJECTIVE To determine whether particular properties of hair are associated with susceptibility to pilonidal sinus disease, we compared physical properties of hairs of patients with pilonidal sinus disease with hairs from control subjects who were matched for sex, BMI, and age. DESIGN This was an experimental study with establishment of a mechanical strength test for single hairs to quantify the maximum vertical force that a hair could exert, following tests of strength of occipital, lumbar, and intergluteal hair. SETTINGS Hair from patients with pilonidal sinus disease and matched control subjects were harvested from patients of the St. Marienhospital Vechta Department of Procto-Surgery. PATIENTS A total of 17 adult patients with pilonidal sinus disease and 217 control subjects were included. MAIN OUTCOME MEASURES ANOVA and intraclass and interclass variations of data gained from mechanical strength tests of occipital, lumbar, and intergluteal hair were included. RESULTS Vertical hair strength was significantly greater in patients with pilonidal sinus disease. Occipital hair exhibited 20% greater, glabella sacralis 1.1 times greater, and intergluteal hair 2 times greater strength in patients with pilonidal sinus disease than in matched control subjects (all p = 0.0001). In addition, patients with pilonidal sinus disease presented with significantly more hair at the glabella sacralis and in the intergluteal fold. LIMITATIONS The study was limited by its relatively small number of patients from a specific cohort of European patients. CONCLUSIONS Occipital hair exhibited considerable vertical strength. Because occipital hair exerted the greatest force and cut hair fragments were found in the pilonidal nest in large quantities, these data suggest that pilonidal sinus disease is promoted by occipital hair. See Video Abstract at http://links.lww.com/DCR/A435.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Lüdi, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1530-0358

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

13 Nov 2017 12:12

Last Modified:

23 Jan 2018 12:13

Publisher DOI:

10.1097/DCR.0000000000000795

PubMed ID:

28796737

BORIS DOI:

10.7892/boris.105777

URI:

https://boris.unibe.ch/id/eprint/105777

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