Dear Editor,
Pilonidal sinus disease (PSD) affects large numbers of predominantly young patients worldwide, yet continues to be characterized by heterogeneous surgical approaches, inconsistent outcome definitions, and insufficient long-term follow-up. For such a high-volume condition, fragmented evidence is no longer sustainable.
At a time of rising patient numbers and increasing expectations for evidence-based care, scientifically grounded management of PSD has become more necessary than ever.
Importantly, PSD represents a substantial burden among adolescents and young adults in Türkiye, underscoring the urgency for structured, evidence-driven management strategies. At the same time, the growing number of high-quality Turkish publications reflects increasing national awareness and commendable academic engagement in this field.1
The Turkish Journal of Colorectal Disease contributes meaningfully to this evolving landscape by providing a respected academic platform for colorectal and pilonidal research. Together with other dedicated international journals and investigators, it helps sustain scientific focus on a disease that has long been underestimated.
This momentum is further reflected by the Turkish Congress for Pilonidal Disease 2025 in İstanbul, which represents a strong signal of national commitment to advancing pilonidal science and clinical care. However, publications and scientific meetings alone are not sufficient to resolve the methodological challenges that continue to limit comparability and long-term progress in this field.
The next step forward requires structured collaboration: harmonized definitions, meaningful long-term outcome assessment, shared datasets, and transparent comparison of surgical strategies across centers and countries.
PiloNERDs International (Pilonidal Network for Expertise, Research, and Development) represents one such initiative. As a clinician-led, globally connected framework, it seeks to facilitate coordinated multicenter research, methodological alignment, and transparent outcome reporting. By encouraging collaboration across institutions, it aims to support the development of more robust evidence and clearer standards in the management of PSD.
Recent multicenter analyses conducted within this collaborative framework have examined long-term outcomes of established techniques and the impact of surgical case load on recurrence rates, contributing to a more data-driven understanding of pilonidal disease management.2, 3
Clinicians and researchers committed to strengthening methodological rigor and collaborative research in pilonidal disease may consider engaging in structured international initiatives that promote standardized reporting and shared scientific development.
