TITLE:
Surgical Knot Strength in Continuous Wound Closures
AUTHORS:
Anthony Nigliazzo, Rodrigo Arrangoiz, Richard Hutchison, Marc Basson, Andrew Saxe
KEYWORDS:
Knot Strength, Continuous Suture, Square Knot, Slip Knot
JOURNAL NAME:
Surgical Science,
Vol.2 No.4,
June
23,
2011
ABSTRACT: Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04; sliding 10.72 +/– 1.35; and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%; sliding 83.4%; hybrid 85.2%. Significant dif-ferences (p