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surgical outreach low middleincome countries lmics organizations high income countries rise help address growing burden conditions warranting surgery however concerns remain impact sustainability outreach leading organizations eg world health organization advocate capacitybuilding approach ensure safety quality sustainability local healthcare system despite knowledge guidelines exist inform efforts aimed develop clinical practice guidelines cpgs support capacitybuilding orthopaedic surgical outreach utilizing multistakeholder international voting panel followed modified american academy orthopaedic surgeons aaos cpg development process systematically reviewed existing literature across 7 predefined capacitybuilding domains partnership professional development governance community impact finance coordination culture writing panel composed 6 orthopaedic surgeons extensive experience surgical outreach reviewed existing literature developed consensusbased cpg domain created international voting panel orthopaedic surgeons administrators leadership roles outreach organizations hospitals outreach organizations partner members individually reviewed cpgs voted approve disapprove guideline cpg considered approved 80 panel members voted approve international voting panel 14 surgeons administrators 6 countries approved 7 cpgs cpg provides recommendations capacitybuilding specific domain example domain partnership cpg recommends development documented plan ongoing bidirectional partnership outreach organization local team domain professional development cpg recommends development needsbased curriculum focused surgical nonsurgical patient care utilizing didactic handson techniques orthopaedic surgical outreach grows bestpractice cpgs inform capacitybuilding initiatives help ensure resources efforts optimized support sustainability care delivery local sites guidelines reviewed updated future evidence supports capacitybuilding lmics evolvesthe global burden disease warranting surgery substantial morbidity mortality otherwise treatable conditions remain disproportionately high low middleincome countries lmics12 estimated 2 million 40 injuryrelated deaths lmics could avoided annually mortality rates reduced level highincome countries hics3 despite progress toward improved access safe timely surgery resourcepoor areas slow historically nongovernmental organizations ngos tried address unmet surgical needs shortterm outreach trips however growing criticism highlighted limitations shortterm trips including limited followup increased burden local workforce depletion local resources46 light ongoing concerns public health priorities shifted toward models emphasize longterm capacitybuilding rather shortterm care delivery capacitybuilding approach healthcare development builds independence infrastructure development sustainability enhanced problemsolving taking context account78