The Effect of Knotting Method on the Structural Properties of Large Diameter Nonabsorbable Monofilament Sutures |
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| Authors: | Douglas J Huber DVM MS Diplomate ABVP Erick L Egger DVM Diplomate ACVS Susan P James PhD |
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| Institution: | Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1620, USA. |
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| Abstract: | OBJECTIVE: To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials. STUDY DESIGN: In vitro mechanical evaluation. METHODS: A conventional square knot was compared with the surgeon's knot, sliding half-hitch, and clamped square knot. Knotted suture loops were created in a uniform manner and acutely tensioned to failure (20 mm/min loading rate; n = 20 per knot type for each material). Stiffness, yield, and failure characteristics of USP #2 nylon, #2 polybutester, #2 polypropylene, 27 kg test monofilament nylon fishing line, and 27 kg nylon leader material were evaluated. RESULTS: Compared with a conventional square knot, a surgeon's knot decreased stiffness for #2 polypropylene, 27 kg fishing line, and 27 kg leader (P < .05). A sliding half-hitch weakened all materials except 27 kg leader (P < .05). Clamping the first throw of a square knot increased the stiffness of 27 kg leader loops (P < .05). CONCLUSIONS: Based on clinically relevant parameters (stiffness and yield), knotting method had no effect on #2 nylon and #2 polybutester. The surgeon's knot is not recommended for #2 polypropylene and 27 kg fishing line and leader material. A sliding half-hitch decreased the yield of leader material. Clamping the first throw of a square knot had no adverse effects on acute properties of tested materials; it increased the stiffness for leader material. CLINICAL RELEVANCE: Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension. |
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