title: Mechanical performance of surgical knots in a vaginal surgery model.
abstract: OBJECTIVE
  To evaluate the integrity of 3 different types of sliding knots in a vaginal surgery model.
  
  
  METHODS
  Nonidentical sliding (NS), loop-to-strand sliding (LTS), and parallel sliding (PS) knots with 4 throws each were tied on a vaginal surgery model with 0 polyglactin-910 and tested until failure. The main outcomes studied were the maximum load reached at failure and the proportion of each type of sliding knot that either unraveled or broke during standardized laboratory testing.
  
  
  RESULTS
  PS knots were significantly stronger than either NS or LTS knots, with no difference in strength between NS and LTS knots. Most of the NS and LTS knots failed by slippage, where as most of the PS knots failed by rupture at the knot site.
  
  
  CONCLUSIONS
  PS knots using 0-vicryl are significantly stronger than NS and LTS knots and should be preferentially considered when performing vaginal surgery.
authors.affiliation: Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032, USA. sunil.balgobin@utsouthwestern.edu
authors.forename: Sunil
authors.initials: S
authors.lastname: Balgobin
authors.forename: Cherine A
authors.initials: CA
authors.lastname: Hamid
authors.forename: Spencer A
authors.initials: SA
authors.lastname: Brown
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Wai
mesh_terms: D005260:Female; D006801:Humans; D008422:Materials Testing; D008953:Models, Anatomic; D011098:Polyglactin 910; D013536:Suture Techniques; D013718:Tensile Strength; D014621:Vagina / Q000601:surgery*
chemical_list: D011098:Polyglactin 910