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Technical considerations in manual and instrument tying techniques.

J D James1, M M Wu, E K Batra

  • 1Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville 22908.

The Journal of Emergency Medicine
|July 1, 1992
PubMed
Summary
This summary is machine-generated.

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Instrument ties create secure granny and square knots in nylon sutures, failing by breakage. Manual square knots are secure, but manual granny knots often slip, indicating technique impacts surgical knot security.

Area of Science:

  • Surgical techniques
  • Materials science
  • Biomedical engineering

Background:

  • Surgical knots are crucial for wound closure and device fixation.
  • Knot security is paramount to prevent complications like slippage and dehiscence.
  • Nylon sutures are commonly used in various surgical procedures.

Purpose of the Study:

  • To compare the security of granny and square knots tied using two-hand (manual) versus instrument tie techniques.
  • To evaluate knot security in both multifilament and monofilament nylon sutures.
  • To determine failure modes (breakage vs. slippage) associated with different knot types and tying methods.

Main Methods:

  • Construction of granny and square knots using both two-hand (manual) and instrument tie techniques.

Related Experiment Videos

  • Utilizing both multifilament and monofilament nylon sutures for knot construction.
  • Assessing knot security through standardized testing to observe failure modes.

    • Main Results:

    • Instrument tie techniques consistently produced secure granny and square knots, with failures occurring due to suture breakage.
    • Two-hand (manual) tie techniques resulted in secure square knots, also failing by breakage.
    • Granny knots tied manually exhibited unreliable security, frequently failing by slippage.

    Conclusions:

    • Instrument tying is a reliable method for achieving secure knots with nylon sutures, minimizing slippage risk.
    • While manual square knots offer good security, manual granny knots are prone to slippage and should be used with caution.
    • Surgical technique significantly influences knot security, impacting the overall integrity of surgical closures.