{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:19:13Z","timestamp":1785507553759,"version":"3.56.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pilonidal abscess is common in adolescents and recurs frequently. Management requires wound care, follow-up, and access to surgical resources, all factors that are influenced by social determinants of health (SDOH). Whether neighborhood-level disadvantage, measured by the Area Deprivation Index (ADI), affects treatment location, follow-up, or recurrence in pediatric patients is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed pediatric patients (&lt;18\u00a0years) treated for pilonidal abscess during 2020-2024. Addresses were geocoded for 2020 ADI scores. Treatment was categorized as emergency department (ED) I&amp;D, operating room (OR) I&amp;D, or non-procedural. ADI was the primary exposure; race and ethnicity were secondary. Outcomes included treatment location, 30-day follow-up, and 6-month recurrence. Bivariate analyses and univariable logistic regression were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 133 encounters, mean age was 15.6\u00a0years and 68% were female. Median national ADI was 76 (IQR 48-89). ADI was not associated with treatment location, follow-up, or recurrence. Race was associated with 30-day follow-up (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004); 59% of Black patients missed follow-up compared with 31% of non-Black patients. Ethnicity was associated with treatment location (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015); Hispanic patients had lower odds of OR management (OR 0.38, 95% CI 0.15-0.91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this predominantly high-disadvantage cohort, racial and ethnic disparities in pilonidal abscess management were identified despite no detectable ADI association. Persistence of patient-level disparities despite uniformly high ADI suggests that census-level metrics may lack the granularity to capture barriers relevant to acute pediatric surgical care. These preliminary observations, limited by narrow ADI dispersion, warrant prospective, multi-institutional confirmation with granular SDOH variables and multivariable modeling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261474194","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:44:06Z","timestamp":1785303846000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Race, Area Deprivation, and Patterns of Care in Pediatric Pilonidal Disease"],"prefix":"10.1177","author":[{"given":"Kaleb M.","family":"Keener","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley","family":"Anderson Feltracco","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie R.","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carisa","family":"Bergner","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bantchev","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel L.","family":"Abebrese","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose H.","family":"Salazar","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001237"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.02.055"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.06.071"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sopen.2025.01.001"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpsurg.2023.101300"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.48865"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2024.03.033"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.03.035"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/as9.0000000000000488"},{"key":"e_1_3_6_13_2","unstructured":"University of Wisconsin school of medicine and public health. 2020 area deprivation index v3.1. preprint posted online 2020. 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