Presented in part at the ACVS Veterinary Symposium, San Antonio TX, October 2013.
Original Article: Research
Knot security and tensile strength of suture materials
Article first published online: 19 NOV 2013
© Copyright 2013 by The American College of Veterinary Surgeons
Volume 43, Issue 1, pages 73–79, January 2014
How to Cite
Marturello, D. M., McFadden, M. S., Bennett, R. A., Ragetly, G. R. and Horn, G. (2014), Knot security and tensile strength of suture materials. Veterinary Surgery, 43: 73–79. doi: 10.1111/j.1532-950X.2013.12076.x
- Issue published online: 2 JAN 2014
- Article first published online: 19 NOV 2013
- Manuscript Accepted: 8 OCT 2013
- Manuscript Received: 17 MAY 2013
To evaluate knot security and tensile failure load of suture tied in simple interrupted, beginning continuous, and ending continuous patterns for 11 suture materials commonly used in small animal surgery.
For each of 11 suture material types, and 5 knot sizes (2, 3, 4, 5, and 6 throws) 2 surgeons each tied 6 knots (n = 12 for each knot size in 11 suture materials). Three types of patterns were evaluated: a simple interrupted square knot, a square knot beginning a simple continuous pattern, and the knot ending a simple continuous pattern. All knots were incubated in healthy canine donor plasma at 40°C for a minimum of 24 hours. Sutures were evaluated for knot security (knots untied, suture failed by breaking, suture slipped from the clamps, or suture untied before testing) and maximum load carried before knot slippage or knot failure (termed tensile failure load).
Significant differences were found in knot security and tensile failure load among suture types. There was no significant difference between the simple interrupted knots and the knots at the beginning of a simple continuous pattern; however, both were significantly less likely to fail than the knots tied at the end of a simple continuous pattern. The number of throws per knot had a significant effect for knot security and tensile failure load. Surgeon experience had a significant effect on failure mode and tensile failure load.
Suture type, number of throws per knot (knot size), suture pattern, and surgeon experience play an important role in knot security and should be considered when performing surgery.