Long-term outcomes of Madrid approach after TAR for complex abdominal wall hernias: a single-center cohort study.

PURPOSE: Undeniably, in the last 2 decades, surgical approaches in the field of abdominal wall repair have notably improved. However, the best approach to provide a durable repair with low morbidity rate has yet to be determined. The purpose of this study is to outline our long-term results following the Transverse Abdominis Release (TAR) approach in patients with complex ventral hernias, focusing on the incidence of recurrence and overall patient satisfaction following surgery. METHODS: This is a retrospective study on 167 consecutive patients who underwent TAR between January 2015 and December 2021 for primary or recurrent complex abdominal hernias. Of these, 117 patients who underwent the open Madrid approach with the use of a double mesh (absorbable and permanent synthetic mesh) were selected and analyzed. A quality of life questionnaire (EuraHS QoL) comparing the preoperative and the postoperative status was administered. RESULTS: Between January 2015 and December 2021, we successfully treated 117 patients presenting with complex ventral defects using the double mesh technique (absorbable and permanent synthetic mesh). Of these, 26 (22.2%) were recurrent cases. At a median follow-up period of 37.7 months, there had been 1 (0.8%) case of recurrence and 8 cases (6.8%) of bulging. The QoL score was significantly improved when compared to the preoperative status in terms of cosmesis, body perception, and physical discomfort. CONCLUSIONS: The Madrid approach for posterior component separation is associated with both a low perioperative morbidity and recurrence rate. In accordance with other studies, we demonstrated that the TAR with reconstruction according to the Madrid approach provides excellent results in the treatment of complex abdominal wall hernias, even at long-term follow-up.

Bilateral metatarsophalangeal valgus and subluxation in two adult llamas treated by medial bone plate arthrodesis.

The clinical signs and diagnostic imaging of two adult llamas with severe metatarsophalangeal valgus angular limb deformity causing metatarsophalangeal instability, severe osteoarthritis and marked bilateral hindlimb lameness are described. The metatarsophalangeal axis was corrected and arthrodesis of the metatarsophalangeal joint was achieved by distal medial metatarsal condylectomy and the medial application of a custom-made angled 4.5 mm dynamic compression plate. A secure construct with normal limb angulation and a good biomechanical outcome was achieved in each of the hindlimbs of both llamas. The development and final dimensions of the implants are described to assist decision making during the evaluation of the surgical management of such cases.

Postal survey of the population of South American camelids in the United Kingdom in 2000/01.

The members of the two leading British camelid breeders associations were surveyed by means of a postal questionnaire between December 2000 and January 2001; 696 questionnaires were posted and 218 usable responses were returned. A total of 3520 camelids were recorded, of which 2719 (77.2 per cent) were alpacas (Lama pacos) and 726 (20.6 per cent) were llamas (Lama glama). Ninety-four per cent of the camelid herds were of one species, and 70 per cent of the animals were kept for more than one purpose. Camelids imported from South America were present on 45 per cent of the units surveyed. Husbandry procedures and preventive health measures were uniform; 92.2 per cent of the animals were kept on pasture all year round, 99 per cent were supplemented with hay and 97.7 per cent with concentrate feed; 88.1 per cent were vaccinated against clostridial disease with a multivalent vaccine licensed for sheep, and 96.3 per cent were treated periodically with anthelmintic drugs. During 2000, ill health, other than dermatological conditions, was reported by 24.3 of respondents, and 32 different conditions were described. Skin disease was reported by 51 per cent of breeders. Zinc deficiency was diagnosed presumptively as the cause of skin disease by 31.9 per cent of the respondents, and ectoparasitism by 26.4 per cent. Of those who treated a skin condition, 71.9 per cent reported an improvement, but less than half of them considered the improvement to have been permanent.

Electrocardiographic parameters of normal alpacas (Lama pacos).

The electrocardiographic parameters of 40 healthy alpacas (Lama pacos) were recorded with a base-apex lead system to establish the normal resting electrocardiographic parameters in this species. The following parameters were measured: heart rate and rhythm, QRS and T morphology, ST segment position, P amplitude and duration, QRS duration and PQ and QT intervals. The heart rate varied between 50 and 110 bpm, with a mean (sd) of 80 (17.8) bpm, and no significant differences were observed between males and females or between alpacas of different ages. Sinus arrhythmia was observed in 35 of the animals, and a regular sinus rhythm was recorded in the other five. The QRS morphology was variable, with an 'rS' pattern observed in 29 animals, 'RS' in six, 'Rs' in three and 'QS' in the other two. A variable morphology was also observed for the T wave, which was positive in 27 animals, negative in seven and biphasic in the other six. All the electrocardiographic parameters were normally distributed and no significant differences were observed between the sexes, except that the amplitude of the P wave was higher in males. The PQ interval was significantly shorter in animals less than six months old.

Comparative study of the efficacy of eprinomectin versus ivermectin, and field efficacy of eprinomectin only, for the treatment of chorioptic mange in alpacas.

The efficacy of eprinomectin versus ivermectin (Study 1: a single-centre, randomised, treatment-controlled, blinded field trial), and the field efficacy of eprinomectin (Study 2: a single-centre, open, un-controlled field trial) for the treatment of chorioptic infestation in naturally infested alpacas were assessed in two studies. Thirty alpacas, all positive for Chorioptes sp. mite, were randomly allocated to two treatment groups in Study 1. Group A received a single topical administration of a 0.5% formulation of eprinomectin at the dose rate of 500mug/kg. Group B received three subcutaneous administrations at 14 days interval of a 1% formulation of ivermectin at the dose rate of 400mug/kg. Response to treatment was assessed by periodic mite count, and skin lesions scored. In Study 2, one group of 19 alpacas received four administrations at weekly interval of topical eprinomectin at the dose rate of 500mug/kg, and response to treatment was monitored by mite counts. No localised or systemic side effects were observed in either trial. There was a statistically significant decrease in mite counts on day 7 (P<0.001) within treatment Groups A and B of Study 1, but mite counts increased again on day 14 and remained high for the duration of the trial in both treatment groups. On day 14 of Study 2, there was a statistically significant reduction in mite counts (P<0.008) and the mite counts remained very low throughout the remainder of the study. The eprinomectin protocol employed in Study 2, consisting of four weekly topical administrations at the dose rate of 500mug/kg of body weight, proved highly effective at reducing the Chorioptes mite burden in alpacas.