New adjustable knot for securing subcuticular running sutures.

The purpose of this study was to determine the influence of surgeon's tying technique on knot security using O and 2-O monofilament and multifilament nylon sutures. By use of an Instron Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. By use of the portable tensiometer, their knot tying techniques were judged to be superior to those used by a cohort of obstetricians and gynecologists. The surgeon's faulty technique can easily be corrected by didactic information and psychomotor skill training.

Suture Techniques↗

PubMed1992

Knotting technique and suture materials.

Three groups of knots were examined using six no. 1 (metric 4) suture materials to identify the most effective and efficient knotting techniques. The three groups were the square or reef knot, the surgeon's knot and a double throw knot. Sequential single additional throws were added to these in order to determine when the strength of the knot reached the breaking force of the material, thus nullifying the need for additional throws. This strength was reached in all cases by a maximum of two additional throws. Suture materials examined were the non-absorbable monofilaments nylon and polypropylene, the absorbable monofilaments polyglyconate and polydioxanone and the braided materials polyglactin and polyglycolic acid, both coated. These were examined for their knot-holding capacity and breaking force to determine the best materials, which were polypropylene, polyglyconate and polyglycolic acid.

Suture Techniques↗