Abandoning scientific colonization in pediatric global surgery: breaking barriers in knowledge dissemination to close gaps in surgical care

Pediatric trauma is a leading cause of death in children and a significant global health concern, with 95% of all childhood injury deaths occurring in low- and middle-income countries (LMICs).1 Approximately 10–15% of pediatric trauma patients suffer blunt abdominal injuries, with the spleen being commonly injured.2 Over the last three decades, based on a series of high-income country (HIC) generated research publications and disseminated English language care guidelines, the management of blunt splenic injury in children in HICs has changed dramatically, from frequent splenectomy to successful non-operative management in more than 90% of patients.2 In Brazil, an LMIC, where only four publications touched on this area in the past 40 years, the splenectomy rate following blunt splenic injury has remained well over 50%, reaching 70% in some regions,2 3 and appropriate Brazilian clinical care guidelines for this condition are lacking.