The effect of knotting method on the structural properties of large diameter nonabsorbable monofilament sutures.
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.
Huber
D J
DJ
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1620, USA.
Egger
E L
EL
James
S P
SP
D000828:Animal Population Groups / Q000601:surgery; D000818:Animals; D009757:Nylons; D011091:Polyesters; D011126:Polypropylenes; D013522:Surgery, Veterinary / Q000379:methods; D013537:Sutures / Q000662:veterinary*
D009757:Nylons; D011091:Polyesters; D011126:Polypropylenes; C048850:polybutester