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Effect of fluid media on the mechanical properties of continuous pattern-ending surgeon’s, square, and Aberdeen knots in vitro.
Abstract: To investigate the knot holding capacity (KHC) of pattern-ending square, surgeon's and Aberdeen knots each tied in 4 throw combinations using large gauge suture after exposure to media commonly found in equine abdominal surgery. Methods: In vitro mechanical study. Methods: Knotted suture strands (n = 10/group). Methods: Strands of 2 polydioxanone or 3 polyglactin 910 were exposed to 1 of 4 media for 15 minutes. Control suture strands remained dry. Media used included balanced electrolyte solution, 1% sodium carboxymethylcellulose, equine serum, or equine fat. Pattern-ending knots for the 3 knot configurations were loaded to failure in a linear fashion on a materials testing machine to determine KHC. Results: Surgeon's knots tied using media-exposed 3 polyglactin 910 had a significantly higher KHC than the same dry knots with 5 and 6 throws. Square knots tied using media-exposed to 3 polyglactin 910 had a significantly higher KHC than the same dry knots at 5 throws. Aberdeen knots tied with either media-exposed 2 polydioxanone or 3 polyglactin 910 had a significantly higher KHC than their equivalent dry knots. Aberdeen knots had a superior KHC, while requiring less suture than both surgeon's and square knots. Conclusions: Media exposure either had no effect on KHC or significantly improved the KHC of all knots investigated. Based on KHC and knot volume, Aberdeen knots tied using media-exposed 3 polyglactin 910 with 3 throws and 1 turn are recommended to end a continuous suture pattern.
© 2017 The American College of Veterinary Surgeons.
Publication Date: 2017-02-02 PubMed ID: 28146293DOI: 10.1111/vsu.12627Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Evaluation Study
- Journal Article
- Animal Studies
- Clinical Pathology
- Clinical Study
- Comparative Study
- Disease Treatment
- Equine Diseases
- Equine Health
- Equine Studies
- Experimental Methods
- In Vitro Research
- In Vivo
- Laboratory Methods
- Mechanical Properties
- Physiology
- Surgery
- Suture
- Veterinary Medicine
- Veterinary Practice
- Veterinary Procedure
- Veterinary Research
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The study researches the effect of certain fluids, usually found during equine abdominal surgery, on the knot holding capacity (KHC) of specific surgical knots when tied with different types of sutures. It found that in most cases, exposure to these fluids either did not change the KHC or actually improved it.
Methods
- The research was conducted as an in vitro mechanical study, using pre-knotted strands of two different types of suture material.
- These strands were then exposed to one of four different fluids commonly present during equine abdominal surgery: balanced electrolyte solution, 1% sodium carboxymethylcellulose, equine serum, or equine fat. Control strands were not exposed to any fluid.
- The research analysed three different types of surgical knot: the square knot, the surgeon’s knot, and the Aberdeen knot. Each knot was tied in up to four different combinations of throws, essentially the loops that make up the knot.
Results
- The KHC of surgeon’s knots tied with 3-polyglactin 910 suture material were found to have significantly higher KHC when they had been exposed to the study’s fluids and had 5 or 6 throws.
- Square knots tied with 3-polyglactin 910 were found to have a significantly higher KHC when exposed to the study’s fluids and had 5 throws.
- Aberdeen knots tied with either of the study’s suture materials had a significantly higher KHC after fluid exposure, regardless of the number of throws.
- Aberdeen knots showed superior KHC overall, despite requiring less suture material than the other knot types.
Conclusions
- The study’s results indicate that exposure to surgical fluids can either have no effect on the KHC of surgical knots, or improve it significantly.
- Based on the results, when taking into account both KHC and knot volume, the researchers recommend the use of Aberdeen knots, specifically those tied with three throws and one turn of 3-polyglactin 910 suture material that’s been exposed to fluid, for ending a continuous suture pattern in equine abdominal surgery.
Cite This Article
APA
Coleridge M, Gillen AM, Farag R, Hanson RR, Munsterman AS.
(2017).
Effect of fluid media on the mechanical properties of continuous pattern-ending surgeon’s, square, and Aberdeen knots in vitro.
Vet Surg, 46(2), 306-315.
https://doi.org/10.1111/vsu.12627 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
- Department of Polymer Engineering, Auburn University, Auburn, Alabama.
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
MeSH Terms
- Animals
- Gastric Juice
- Horse Diseases / surgery
- Horses
- In Vitro Techniques
- Materials Testing / veterinary
- Polydioxanone
- Polyglactin 910
- Stomach Volvulus / surgery
- Stomach Volvulus / veterinary
- Suture Techniques / instrumentation
- Suture Techniques / veterinary
- Tensile Strength
Citations
This article has been cited 4 times.- Pastor T, Zderic I, van Knegsel KP, Berk T, Mechkarska R, Beeres FJP, Gueorguiev B, Pastor T. How many knots are necessary to achieve knot security of two high strength suture tapes? A biomechanical comparative analysis. Arch Orthop Trauma Surg 2024 Dec 16;145(1):43.
- Bushong EE, Janis JE. Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length. Plast Reconstr Surg Glob Open 2024 Aug;12(8):e6047.
- van Knegsel KP, Zderic I, Kastner P, Varga P, Knobe M, Berk T, Gueorguiev B, Pastor T. Knot holding capacity of two different high-strength sutures-a biomechanical analysis. Int Orthop 2024 Mar;48(3):643-649.
- Koninckx PR, Ussia A, Wattiez A, Kondo W, Romeo A. Laparoscopic Surgery: A Systematic Review of Loop and Knot Security, Varying with the Suture and Sequences, Throws, Rotation and Destabilization of Half-Knots or Half-Hitches. J Clin Med 2023 Sep 24;12(19).
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