In vivo knot scoring model for a multifilament suture

Area of Science:

• Surgical innovation
• Biomaterials science
• Wound healing research

Background:

• Surgical knots are crucial for wound closure and tissue support.
• Limited in vivo data exists on surgical knot behavior and evaluation.
• A new knot score model integrates microscopic evaluation and loop-holding capacity.

Purpose of the Study:

• To introduce and validate a knot score model for assessing in vivo surgical knot safety.
• To compare the knot safety of different suture materials in living tissue.
• To provide a standardized method for evaluating knot performance.

Main Methods:

• A double-blinded, comparative study involving 72 rabbits.
• Surgeons placed 720 intramuscular single-loop sutures (Novosyn vs. Vicryl) in the longissimus muscle.
• Knot safety was assessed on day 4 using microscopy, mechanical analysis, and a defined knot score, with statistical analysis via Hodges-Lehmann and Wilcoxon tests.

Main Results:

• Novosyn and Vicryl sutures exhibited comparable knot safety.
• The 95% confidence interval supported the similarity in knot security between the two braided multifilament sutures.
• The developed knot score model effectively classified knot performance.

Conclusions:

• The novel knot score model provides a reliable method for comparing surgical knot safety in vivo.
• Braided multifilament sutures like Novosyn and Vicryl demonstrate similar knot security in the tested model.
• This research contributes to understanding in vivo knot behavior and informs suture selection.