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Abstract：
BACKGROUND: Most remote areas have restricted access to healthcare services and are too small and remote to sustain specialist services. In 2017, the World Society of Emergency Surgery (WSES) published guidelines for the management of intra-abdominal infections. Many hospitals, especially those in remote areas, continue to face logistical barriers, leading to an overall poorer adherence to international guidelines.
METHODS: The aim of this paper is to report and amend the 2017 WSES guidelines for the management of intra-abdominal infections, extending these recommendations for remote areas and low-income countries. A literature search of the PubMed/MEDLINE databases was conducted covering the period up until June 2020.
RESULTS: The critical shortages of healthcare workers and material resources in remote areas require the use of a robust triage system. A combination of abdominal signs and symptoms with early warning signs may be used to screen patients needing immediate acute care surgery. A tailored diagnostic step-up approach based on the hospital\'s resources is recommended. Ultrasound and plain X-ray may be useful diagnostic tools in remote areas. The source of infection should be totally controlled as soon as possible.
CONCLUSIONS: The cornerstones of effective treatment for intra-abdominal infections in remote areas include early diagnosis, prompt resuscitation, early source control, and appropriate antimicrobial therapy. Standardization in applying the guidelines is mandatory to adequately manage intra-abdominal infections.
METHODS: The aim of this paper is to report and amend the 2017 WSES guidelines for the management of intra-abdominal infections, extending these recommendations for remote areas and low-income countries. A literature search of the PubMed/MEDLINE databases was conducted covering the period up until June 2020.
RESULTS: The critical shortages of healthcare workers and material resources in remote areas require the use of a robust triage system. A combination of abdominal signs and symptoms with early warning signs may be used to screen patients needing immediate acute care surgery. A tailored diagnostic step-up approach based on the hospital\'s resources is recommended. Ultrasound and plain X-ray may be useful diagnostic tools in remote areas. The source of infection should be totally controlled as soon as possible.
CONCLUSIONS: The cornerstones of effective treatment for intra-abdominal infections in remote areas include early diagnosis, prompt resuscitation, early source control, and appropriate antimicrobial therapy. Standardization in applying the guidelines is mandatory to adequately manage intra-abdominal infections.
摘要：
背景：大多数偏远地区获得医疗保健服务的机会受到限制，而且规模太小且偏远，无法维持专科服务。2017年，世界急诊外科学会（WSES）发布了腹腔内感染管理指南。很多医院,尤其是那些偏远地区的人，继续面临后勤障碍，导致对国际准则的总体依从性较差。
方法：本文的目的是报告和修订2017年WSES腹内感染管理指南，将这些建议扩展到偏远地区和低收入国家。对截至2020年6月的PubMed/MEDLINE数据库进行了文献检索。
结果：偏远地区医疗工作者和物质资源的严重短缺需要使用强大的分诊系统。腹部体征和症状与早期预警体征的组合可用于筛查需要立即进行急性护理手术的患者。建议采用基于医院资源的定制诊断升级方法。超声和X线平片在偏远地区可能是有用的诊断工具。应尽快完全控制感染源。
结论：偏远地区腹腔感染有效治疗的基石包括早期诊断，迅速复苏，早期源代码控制，和适当的抗菌治疗。应用指南的标准化是强制性的，以充分管理腹腔内感染。
方法：本文的目的是报告和修订2017年WSES腹内感染管理指南，将这些建议扩展到偏远地区和低收入国家。对截至2020年6月的PubMed/MEDLINE数据库进行了文献检索。
结果：偏远地区医疗工作者和物质资源的严重短缺需要使用强大的分诊系统。腹部体征和症状与早期预警体征的组合可用于筛查需要立即进行急性护理手术的患者。建议采用基于医院资源的定制诊断升级方法。超声和X线平片在偏远地区可能是有用的诊断工具。应尽快完全控制感染源。
结论：偏远地区腹腔感染有效治疗的基石包括早期诊断，迅速复苏，早期源代码控制，和适当的抗菌治疗。应用指南的标准化是强制性的，以充分管理腹腔内感染。
