1. In vitro evaluation of square and surgeon's knots in large gauge suture.
- Author
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Gillen AM, Munsterman AS, Farag R, Coleridge MO, and Hanson RR
- Subjects
- Animals, Horses, In Vitro Techniques, Materials Testing veterinary, Stomach Volvulus surgery, Tensile Strength, Horse Diseases surgery, Stomach Volvulus veterinary, Suture Techniques veterinary
- Abstract
Objective: To investigate the strength and size of surgeon's and square knots for starting and ending continuous suture lines using large gauge suture., Study Design: In vitro mechanical study., Study Population: Knotted suture., Methods: Surgeon's and square knots were tested using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone under linear tension on a universal testing machine. Failure mode and knot holding capacity (KHC) were recorded, and relative knot security (RKS) was calculated as a percentage of KHC. Comparisons were made between number of throws, suture size, suture type, and knot types. Knot volume and weight were assessed by a digital micrometer and balance, respectively., Results: There were no significant differences in KHC (P = .295), RKS (P = .307), volume (P = .128), or weight (P = .310) between square and surgeon's knots at the start or end of suture lines with the same number of throws and suture type. A minimum of 6 throws were required for start knots and 7 throws at end knots to prevent unraveling. Knots tied with 3 polyglactin 910 were strongest (P < .001) and 2 polyglactin 910 produced knots with higher KHC and RKS than 2 polydioxanone (P < .001)., Conclusion: No consistent differences were detected between knots types tied with the same suture material; however, number of throws affected KHC and RKS up to 6 throws in start or 7 throws in end knots. The configuration of square and surgeon's knots performed at the end of a continuous line alters their KHC, supporting the use of additional throws for knot security., (© 2017 The American College of Veterinary Surgeons.)
- Published
- 2017
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