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Tensile strength of a surgeon’s or a square knot
Muffly, Tyler M. Boyce, Jamie Kieweg, Sarah L. Bonham, Aaron J.
Muffly, Tyler M.
Boyce, Jamie
Kieweg, Sarah L.
Bonham, Aaron J.
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Abstract
Objective—To test the integrity of surgeon’s knots and flat square knots using four different
suture materials.
Study Design—Chromic catgut, polyglactin 910, silk, and polydioxanone sutures were tied in
the two types of knot configurations. For all sutures, a 0-gauge United States Pharmacopeia suture
was used. Knots were tied by a single investigator (JB). Suture was soaked in 0.9 % sodium
chloride for 60 seconds and subsequently transferred to a tensiometer where the tails were cut to 3
mm length. We compared the knots, measuring knot strength using a tensiometer until the sutures
broke or untied.
Results—A total of 119 knots were tied. We found no difference in mean tension at failure
between a surgeon’s knot (79.7 Newtons) and a flat square knot (82.9 Newtons). Using a Chisquare
test, we did not find a statistically significant difference in the likelihood of knots coming
untied between surgeon’s knots (29%) and flat square knots (38%).
Conclusions—Under laboratory conditions, surgeon’s knots and flat square knots did not differ
in tension at failure or likelihood of untying.
Description
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Date
2014-09-19
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Publisher
Elsevier
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Keywords
Suture techniques, Tensile strength, Suture end length, Polyglactin 910
Citation
Tensile strength of a surgeon’s or a square knot
Tyler M. Muffly, Jamie Boyce, Sarah L. Kieweg, Aaron J. Bonham
J Surg Educ. Author manuscript; available in PMC 2014 September 19.
Published in final edited form as: J Surg Educ. 2010 Jul-Aug; 67(4): 222–226. http://dx.doi.org/10.1016/j.jsurg.2010.06.007