Bursting strength of surgeon’s and self-locking knots for closure of ventral midline celiotomy in horses.

This research article evaluates whether a new type of surgical knot can increase the strength of a ventral midline closure in horses. The researchers found that using the new self-locking knot leads to a 25% stronger closure compared to the traditional surgeon’s knot.

Study Methodology

• The researchers gathered a sample size of 14 equine (horse) cadavers. They performed celiotomy, a procedure for opening the abdominal cavity, on the dead horses through a 20-cm ventral midline incision.
• Each horse was randomly assigned one of two surgical closure types: the novel self-locking knot or the traditional surgeon’s knot.
• A 200L inflatable bladder was placed into the abdominal cavity of each horse and inflated until the surgical closure failed. This was done to test the strength of each knot type.
• The researchers recorded various factors like the breed, age, weight, and the knot combination used for each horse. They also noted the mode of failure, closure time, and bursting strength in millimeters of mercury (mm Hg).

Study Findings

• The results showed that closures using the new self-locking knot, which used a forwarder start with an Aberdeen end knot (F-A), had a greater bursting strength compared to those using the traditional surgeon’s knot, which had a surgeon’s start with a surgeon’s end knot (S-S).
• The median bursting strength for the F-A knot was notably higher at 388 mm Hg, compared to 290 mm Hg for the traditional knot combination. This suggests that the F-A knot combination produced closures that were stronger by an average of 25%.
• Most incisions closed with the F-A knot combination failed along the fascia, or connective tissue, while those with the S-S combination failed at the knot.

Conclusions and Recommendations

• The researchers concluded that the novel self-locking knot combination provided a more secure closure than the traditional surgeon’s knot combination for closing ventral midline incisions in equine cadavers.
• They suggested that using the F-A knot for closing abdominal incisions in horses may be more effective. However, they highlighted that further in vivo investigation (live testing) is needed before they can recommend this new knot combination for clinical use.