The discussion explores a major Lancet-published cluster trial evaluating a simple, low-cost strategy to reduce surgical site infections across seven low- and middle-income countries. Building on earlier global surgery initiatives, the team tested routine glove and instrument changes before fascial closure—an intuitive yet rarely practiced step. Across more than 13,000 abdominal surgeries, this frugal intervention produced a meaningful absolute reduction in infection rates, with consistent benefits in both elective and emergency settings. The conversation highlights the challenge of translating evidence into sustained surgical practice, especially in settings with diverse healthcare structures, and underscores the need for cost-effectiveness data to drive policy adoption. It also points toward broader implications for other surgical fields and future global surgical research efforts.