Riding in jeeps, touring in tanks and taking the bumps of basic training have caused such an increase in pilonidal-cyst disorders that some doctors call them jeep disease. Cause: an infection of a congenital cyst at the base of a man's spine. Chief symptom: it hurts to sit down.
Many a pilonidal cyst is never discovered. Discovery usually results from an infection, or an irritation like a jeep ride or a heavy fall (one doctor calls his lady pilonidal patients "basketball girls").
Standard treatment is to cut out the whole sac, leaving a wound so large that it must be kept partly open to heal gradually. A serviceman needs 60 to 90 days healing time before he can go back on duty. In 1940 the Navy found that the cysts were responsible for more hospitalization than hernia or syphilis. In last week's Southern Medical Journal, Dr. Louis Arthur Buie of the Mayo Clinic said that after draft officials got over being choosy and started sending along pilonidal cyst cases, "overconscientious" Army & Navy surgeons began operating on all cysts, even uninfected "dimples." Purpose: to remove the possibility of a cyst crisis at the front. This zeal put so many men to bed that an order came down saying in effect: "Do not do dimples."
So surgeons limited themselves to the infected, jeep-riding cases, vied in thinking up ways to cut healing time. One method, the closed technique: stitch the wound up tight to make the edges heal directly together. Dr. Buie does not approve of the closed technique, gives statistics to show that infected cysts recur in about a quarter of the people so treated.
To cut the healing time safely, he offers a compromise technique. First Dr. Buie determines the direction of the cyst's channels with a probe. Then he opens up each channel, removes the normal skin above it and, if the cyst wall is reasonably healthy, stitches the wall to the surrounding skin. By using the cyst wall as skin, Dr. Buie avoids wasting much tissue. Average healing time is 30 days.
Lieut. Commander Joseph Jerome Sher in the Naval Medical Bulletin sidesteps the whole open *y. closed debate, recommends using the X-ray technique for 30 days in each cyst case before resorting to surgery. Reason: X rays in sufficient quantity will sometimes dry up a cyst, making an operation unnecessary. Advantage of this method: a patient can be on duty all the time except when he comes in for treatment.
*Rhymes with idle. Literally "hair-nest," so called because hairs grow inside the cyst. A pi lonidal cyst is supposed to result from imperfect fusion of the two halves of a body in fetal life.
A piece of skin gets folded inside, making a sac, usually with one or more small openings (called sinuses). This happens to one individual in 940.