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The Effect of Knotting Method on the Structural Properties of Large Diameter Nonabsorbable Monofilament Sutures

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To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials. Study Design

In vitro mechanical evaluation. Methods

A conventional square knot was compared with the surgeon's knot, sliding half-hitch, and clamped square knot. Knotted suture loops were created in a uniform manner and acutely tensioned to failure (20 mm/min loading rate; n = 20 per knot type for each material). Stiffness, yield, and failure characteristics of USP #2 nylon, #2 polybutester, #2 polypropylene, 27 kg test monofilament nylon fishing line, and 27 kg nylon leader material were evaluated. Results

Compared with a conventional square knot, a surgeon's knot decreased stiffness for #2 polypropylene, 27 kg fishing line, and 27 kg leader ( P < .05 ). A sliding half-hitch weakened all materials except 27 kg leader ( P < .05 ). Clamping the first throw of a square knot increased the stiffness of 27 kg leader loops ( P < .05 ). Conclusions

Based on clinically relevant parameters (stiffness and yield), knotting method had no effect on #2 nylon and #2 polybutester. The surgeon's knot is not recommended for #2 polypropylene and 27 kg fishing line and leader material. A sliding half-hitch decreased the yield of leader material. Clamping the first throw of a square knot had no adverse effects on acute properties of tested materials; it increased the stiffness for leader material. Clinical Relevance

Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension.

©Copyright 1999 by The American College of Veterinary Surgeons
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Document Type: Research Article

Affiliations: From the Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.

Publication date: 1999-07-01

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