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Square not a running knot.

Harald L Aanning1, Tara Haas, David R Jorgensen

  • 1Department of Surgery, Yankton Medical Clinic, Yankton, SD, USA.

Journal of the American College of Surgeons
|February 28, 2007
PubMed
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Running polypropylene sutures anchored with half hitches are stronger than those tied with square knots. Square knots weaken the suture, causing breakage under tension, unlike half hitches.

Area of Science:

  • Surgical Materials Science
  • Biomedical Engineering

Background:

  • Comparison of tensile strength in running monofilament polypropylene sutures.
  • Evaluation of anchoring techniques: square knots versus half hitches.

Purpose of the Study:

  • To determine the mechanical strength differences between polypropylene sutures secured with square knots and half hitches.
  • To identify failure mechanisms in running suture knots.

Main Methods:

  • Polypropylene sutures (sizes 0 to 5-0) were tested on a tensionometer.
  • Sutures were anchored using either square knots or half hitches.
  • Recorded breaking force and location of suture failure.

Main Results:

  • Sutures with square knots exhibited 75% of the strength of those with half hitches (p<0.001).

Related Experiment Videos

  • Square knot sutures failed at the knot, where throws converted to half hitches under tension.
  • Electron microscopy revealed suture distortion and weakening at square knot failure points.

    • Conclusions:

    • Half hitch anchoring provides superior strength and safety for running polypropylene sutures compared to square knots.
    • Square knots compromise suture integrity, leading to premature failure.
    • Half hitches maintain suture strength without surface defects or knot failure.