A study of slippage of various knot configurations

Abstract

Eye

How to knot bury and not break the suture: the 3-1-bury-1 knot

“…4 In another study, the slip knot and modified slip knot demonstrated greater than 2 times more slippage after 24 hours than the surgeon's knot. 7 Herein, we present an alternative technique for tying a 3-1-1 square knot, reducing its crosssectional area while burying the knot, thus reducing the likelihood of suture breakage.…”

“…Each of these techniques produces a smaller knot that requires less force when burying. 4,7,8 The slip knot and modified slip knot in particular offer the additional benefit of tension adjustment until after the third throw. The trade-off, however, is that these alternatives produce sutures with reduced tensile strength compared with the traditional 3-1-1 technique.…”

“…5,6 Therefore, prominent corneal nerves in a clear corneal stroma may be the first clue of MEN2B, particularly in combination with multiple neuromas of conjunctiva, eyelids, lips, and tongue. 5,7 Early diagnosis of MEN2B provides a narrow window of opportunity for prophylactic thyroidectomy to prevent medullary thyroid carcinoma. 8 However, 10 cases of prominent corneal nerves and mucosal neuromas, but no evidence of medullary thyroid carcinoma, adrenal pheochromocytoma, or RET gene mutations, have previously been described in the literature.…”