A mechanical study of ligature security of commercially available pre-tied ligatures versus hand tied ligatures for use in equine laparoscopy.
OBJECTIVE
To determine a hand-tied ligature knot configuration, suture size, and suture type that would be an acceptable substitute to commercially available ligature knots for use in equine laparoscopic surgery.


METHODS
Three-factor ANOVA with the fixed effects being suture type, suture size, and knot type. The dependent variable was ligature security (load to failure).


METHODS
Commercially available Endoloop and 4 hand-tied slipknot ligatures were compared with a 4-layer square knot. The hand tied ligature knots tested were the 4S modified Roeder knot, the Brooks knot, the modified Roeder knot, and the Weston knot. Two suture sizes (0, 2) of each of 2 suture types (polydioxanone, polyglactin 910) were tested with each hand tied knot. Two types (polydioxanone, polyglactin 910) of size 0 Endoloop were tested. Twenty repetitions of each knot suture type were tested for force to yield on a materials testing machine. Statistical analysis consisted of a 3-way ANOVA with individual comparisons made using the Bonferroni method. Significance was P< or = .05.


RESULTS
Only the 4S modified Roeder knot in 2 polydioxanone (103 N) was comparable with the breaking strength of the square knots (157 N). All other knot suture combinations tested were significantly weaker than the square knot (range, 2-18 N).


CONCLUSIONS
For equine laparoscopy, a 2 polydioxanone 4S modified Roeder knot would be an acceptable alternative to the commercially available Endoloop.


CONCLUSIONS
Laparoscopic slip knots are commonly used in equine laparoscopic surgery. Various knot configuration and suture size and type combinations will affect the security of the slip knot.
Carpenter
Elaine M
EM
College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523, USA.
Hendrickson
Dean A
DA
James
Susan
S
Franke
Chad
C
Frisbie
David
D
Trostle
Steven
S
Wilson
David
D
D000704:Analysis of Variance; D000818:Animals; D004868:Equipment Failure; D006736:Horses / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary; D008422:Materials Testing; D016687:Polydioxanone; D011098:Polyglactin 910; D011108:Polymers; D013536:Suture Techniques / Q000662:veterinary*; D013537:Sutures / Q000662:veterinary*; D013718:Tensile Strength
D011108:Polymers; D016687:Polydioxanone; D011098:Polyglactin 910