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Related Experiment Videos

Tying a loop-to-strand suture: is it safe?

Jason Hurt1, James B Unger, Joseph J Ivy

  • 1Division of Gynecologic Pelvic Surgery, Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, Shreveport, LA, USA.

American Journal of Obstetrics and Gynecology
|April 23, 2005
PubMed
Summary

The loop-to-strand knot is reliable for continuous sutures when secured with a 6-throw flat square knot, but fails at an unacceptable rate when tied using sliding knots.

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Area of Science:

  • Surgical techniques
  • Biomaterials science
  • Suture biomechanics

Background:

  • Continuous sutures are common in surgical closures.
  • Secure knot tying is crucial for suture integrity.
  • Poliglecaprone 25 is a widely used synthetic absorbable suture.

Purpose of the Study:

  • To assess the integrity of loop-to-strand knots.
  • To compare the performance of square knots versus sliding knots.
  • To evaluate knot security with poliglecaprone 25 sutures.

Main Methods:

  • Tested loop-to-strand knots using poliglecaprone 25 sutures (0 and 2-0 gauges).
  • Compared three knot configurations: single-to-single square, loop-to-single square, and loop-to-single sliding knots.
  • Evaluated knot untying rates and ultimate load to failure for each knot type.

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Main Results:

  • Loop-to-strand knots tied with a flat square knot demonstrated high integrity.
  • Knots tied with a nonidentical sliding knot exhibited an unacceptably high failure rate.
  • Performance was consistent across both tested suture gauges.

Conclusions:

  • A 6-throw flat square knot provides acceptable security for loop-to-strand suture termination.
  • Sliding knots are not recommended for loop-to-strand termination due to high failure rates.
  • Suture knot security is dependent on the specific knot configuration used.