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Running sutures anchored with square knots are unreliable
H L Aanning1, Andrew Van Osdol, Chantal Allamargot
1Yankton, SD 57078, USA. laanning@gmail.com
American Journal of Surgery
|April 13, 2012
Summary
Square knots significantly weaken running sutures compared to half hitches. This finding suggests reconsidering square knot use in surgical closures for improved suture strength and patient safety.
Area of Science:
- Surgical Materials Science
- Biomedical Engineering
- Wound Closure Techniques
Background:
- Previous research indicated square knots reduced polypropylene suture strength by 25% compared to half hitches.
- The current study aimed to determine if this strength reduction applies to other suture types in continuous closures.
Purpose of the Study:
- To evaluate the impact of anchor knot geometry (square knot vs. half hitch) on the tensile strength of various running sutures.
- To provide data for optimizing surgical knot selection in continuous wound closure.
Main Methods:
- Three-zero (3-0) monofilament and multifilament sutures were tested.
- Sutures were anchored using either square knots or half hitches on a tensionometer.
- Tensile force at breakage and failure site were recorded.
Main Results:
- Running sutures anchored with square knots retained only 50% to 84% of the strength of sutures secured with half hitches.
- This difference in strength was statistically significant (P < .001).
Conclusions:
- Half hitches provide superior tensile strength for running sutures compared to square knots.
- The findings necessitate a re-evaluation of the routine use of square knots for anchoring running sutures in surgical practice.
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