INTRODUCTION
Pilonidal sinus disease (PSD) remains one of the most frequent benign surgical conditions affecting adolescents and young adults worldwide. While particularly common in Türkiye, PSD also represents a substantial clinical burden across Northern Europe and North America, with steadily increasing incidence reported throughout large parts of Asia. Despite its global prevalence, management strategies remain strikingly heterogeneous.
Türkiye occupies a unique position in this landscape (1). The disease is encountered with high frequency, and Turkish surgeons have demonstrated strong and sustained academic engagement, reflected in numerous publications (2), focused conference sessions, and lively national discourse. This commitment was most recently highlighted by the dedicated Pilonidal Sinus Disease Congress in İstanbul in 2025, organised under the leadership of Çiğdem Arslan—a clear signal of national momentum and professional investment in advancing pilonidal care.
Yet, despite this impressive national activity, international integration of data, methodology, and outcome assessment remains weak. Surgical techniques vary widely between centres; definitions of recurrence and healing lack harmonisation; and follow-up periods are frequently too short to allow meaningful comparison. For a disease of such prevalence and socio-economic impact, fragmented evidence is no longer acceptable. Our patients deserve standards derived from structured, transparent, and reproducible science.
The Turkish Journal of Surgery plays an important role in shaping academic dialogue and disseminating high-quality surgical research. Given the substantial burden of PSD within Türkiye’s young population (3), the journal is uniquely positioned to foster broader scientific alignment and international visibility in this field.
However, publications and meetings alone are no longer sufficient.
The next step must be deliberate and organised cross-border collaboration: Shared registries, harmonised outcome definitions, consensus on meaningful long-term follow-up, multicentre data pooling, and open methodological exchange. Without such structure, variability will persist, and progress will remain incremental rather than transformative.
In response to this need, PiloNERDs International (Pilonidal Network for Expertise, Research, and Development) was established as a clinician-led, globally connected framework dedicated exclusively to pilonidal disease. Its purpose is practical and outcome-oriented. By aligning definitions, encouraging rigorous long-term assessment, facilitating collaborative research projects, and providing structured educational resources, the network seeks to elevate both scientific quality and everyday surgical care.
Türkiye—with its high case volume and demonstrably strong professional interest—represents a pivotal partner in this endeavour. Greater international collaboration will not dilute national expertise; rather, it will amplify it. Shared datasets increase statistical power. Harmonised methodology enhances comparability. Transparent exchange accelerates innovation. Most importantly, structured cooperation directly benefits the predominantly young patients entrusted to our care.
The surgical community stands at a point where isolated excellence must evolve into coordinated progress. The urgency is clear. Scientific rigour, methodological discipline, and collaborative openness are no longer optional—they are prerequisites for responsible patient care.
Discover more at www.pilonerds.com.
Clinicians and researchers are therefore warmly invited to engage actively with PiloNERDs International: To contribute data, participate in collaborative projects, refine definitions, and help shape the standards that will define the next generation of pilonidal surgery.
