title: Knot security and tensile strength of suture materials.
abstract: OBJECTIVE
  To evaluate knot security and tensile failure load of suture tied in simple interrupted, beginning continuous, and ending continuous patterns for 11 suture materials commonly used in small animal surgery.
  
  
  METHODS
  Mechanical study.
  
  
  METHODS
  For each of 11 suture material types, and 5 knot sizes (2, 3, 4, 5, and 6 throws) 2 surgeons each tied 6 knots (n = 12 for each knot size in 11 suture materials). Three types of patterns were evaluated: a simple interrupted square knot, a square knot beginning a simple continuous pattern, and the knot ending a simple continuous pattern. All knots were incubated in healthy canine donor plasma at 40°C for a minimum of 24 hours. Sutures were evaluated for knot security (knots untied, suture failed by breaking, suture slipped from the clamps, or suture untied before testing) and maximum load carried before knot slippage or knot failure (termed tensile failure load).
  
  
  RESULTS
  Significant differences were found in knot security and tensile failure load among suture types. There was no significant difference between the simple interrupted knots and the knots at the beginning of a simple continuous pattern; however, both were significantly less likely to fail than the knots tied at the end of a simple continuous pattern. The number of throws per knot had a significant effect for knot security and tensile failure load. Surgeon experience had a significant effect on failure mode and tensile failure load.
  
  
  CONCLUSIONS
  Suture type, number of throws per knot (knot size), suture pattern, and surgeon experience play an important role in knot security and should be considered when performing surgery.
authors.affiliation: Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Marturello
authors.forename: Michael S
authors.initials: MS
authors.lastname: McFadden
authors.forename: R Avery
authors.initials: RA
authors.lastname: Bennett
authors.forename: Guillaume R
authors.initials: GR
authors.lastname: Ragetly
authors.forename: Gavin
authors.initials: G
authors.lastname: Horn
mesh_terms: D000818:Animals; D004285:Dogs / Q000601:surgery; D004868:Equipment Failure / Q000662:veterinary; D013522:Surgery, Veterinary / Q000295:instrumentation; D013536:Suture Techniques / Q000592:standards / Q000662:veterinary*; D013537:Sutures / Q000592:standards / Q000662:veterinary*; D013718:Tensile Strength