Tyler M Muffly1, Jamie Boyce, Sarah L Kieweg, Aaron J Bonham. 1. Center of Urogynecology and Pelvic Floor Disorders, Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. mufflyt@ccf.org
Abstract
OBJECTIVE: To test the integrity of surgeon's knots and flat square knots using 4 different suture materials. STUDY DESIGN: Chromic catgut, polyglactin 910, silk, and polydioxanone sutures were tied in the 2 types of knot configurations. For all sutures, a 0-gauge United States Pharmacopeia suture was used. Knots were tied by a single investigator (J.B.). The suture was soaked in 0.9% sodium chloride for 60 s and subsequently transferred to a tensiometer where the tails were cut to 3-mm length. We compared the knots, measuring knot strength with a tensiometer until the sutures broke or untied. RESULTS: A total of 119 throws were tied. We found no difference in mean tension at failure between a surgeon's knot (79.7 N) and a flat square knot (82.9 N). Using a chi(2) test, we did not find a statistically significant difference in the likelihood of knots coming untied between surgeon's knots (29%) and flat square knots (38%). CONCLUSIONS: Under laboratory conditions, surgeon's knots and flat square knots did not differ in tension at failure or in likelihood of untying. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
OBJECTIVE: To test the integrity of surgeon's knots and flat square knots using 4 different suture materials. STUDY DESIGN: Chromic catgut, polyglactin 910, silk, and polydioxanone sutures were tied in the 2 types of knot configurations. For all sutures, a 0-gauge United States Pharmacopeia suture was used. Knots were tied by a single investigator (J.B.). The suture was soaked in 0.9% sodium chloride for 60 s and subsequently transferred to a tensiometer where the tails were cut to 3-mm length. We compared the knots, measuring knot strength with a tensiometer until the sutures broke or untied. RESULTS: A total of 119 throws were tied. We found no difference in mean tension at failure between a surgeon's knot (79.7 N) and a flat square knot (82.9 N). Using a chi(2) test, we did not find a statistically significant difference in the likelihood of knots coming untied between surgeon's knots (29%) and flat square knots (38%). CONCLUSIONS: Under laboratory conditions, surgeon's knots and flat square knots did not differ in tension at failure or in likelihood of untying. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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