title: The effect of knotting method on the structural properties of large diameter nonabsorbable monofilament sutures.
abstract: OBJECTIVE
  To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1620, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Huber
authors.forename: E L
authors.initials: EL
authors.lastname: Egger
authors.forename: S P
authors.initials: SP
authors.lastname: James
mesh_terms: D000828:Animal Population Groups / Q000601:surgery; D000818:Animals; D009757:Nylons; D011091:Polyesters; D011126:Polypropylenes; D013522:Surgery, Veterinary / Q000379:methods; D013537:Sutures / Q000662:veterinary*
chemical_list: D009757:Nylons; D011091:Polyesters; D011126:Polypropylenes; C048850:polybutester