Effect of tying conditions on the knot security of suture materials

Abstract

Although the knot security of suture materials has been widely investigated, there are few reports on the effects of knot tying conditions. With respect to foreign body reaction, it is preferable to use the minimum possible amount of suture materials and to use an appropriate material to ensure knot security. In this study, the different effects of knot tying conditions, such as knot type, tying force, and tying speed, were investigated. Knot tying was performed by a tensile tester for reproducible testing with the least amount of hand tying variation. The square knot (1 5 1 5 1) was shown to be the most appropriate knot type to evaluate monofilament sutures with a tensile tester. Increasing the tying speed and tying force enhanced knot security. The mechanical tying method was found to be a useful alternative to hand tying and provided reproducible test results.

Pedicle ligation in ovariohysterectomy: an in vitro study of ligation techniques

“…In this study a KTF was set that could be replicated consistently using weights or operator hand tying. Weights were utilised to standardise forces on the knot after placement (Botet and others ), rather than tensometers (Im and others ) or pull spring scales (Rosin and Robinson , Huber and others ). Load was applied in our model after each of the first two throws rather than only after the second throw (Im and others ).…”

“…Weights were utilised to standardise forces on the knot after placement (Botet and others ), rather than tensometers (Im and others ) or pull spring scales (Rosin and Robinson , Huber and others ). Load was applied in our model after each of the first two throws rather than only after the second throw (Im and others ). The authors felt that this methodology better mimicked in vivo reality and ensured consistency in the first two throws critical for loop security and vessel occlusion (Faulkner and others , Mulon and others ).…”

“…It has been reported that speed and tension of the knot tie are important factors in knot security (Rosin and Robinson , Im and others ). They could also be considered important variables in ovarian pedicle ligation, particularly for inexperienced surgeons.…”

Review Paper: Absorbable Polymeric Surgical Sutures: Chemistry, Production, Properties, Biodegradability, and Performance

“…As knotting induces decrease in mechanical properties, better methods of selection and tying of suture materials are required to ensure maintenance of the tensile and knot security properties. Introduction of mechanical tying method was found to be a useful alternative to hand tying and provided reproducible test results [330,331]. The mechanical properties of damaged suture are important to all surgeons who use suture arthroscopically.…”

Knot Security: How Many Throws Does It Really Take?

“…When approximating tissue edges, whether skin, tendon, or muscle, the surgeon must also balance excess foreign material with knot security. 1 A throw refers to a specific step or layer used to create a knot, and a knot is composed of >2 throws in succession. 2 Knot security is defined as a knot that fails by suture fracture prior to untying by slippage.…”