In vitro evaluation of the knot-holding capacity and security, weight, and volume of forwarder knots tied with size-3 polyglactin 910 suture exposed to air, balanced electrolyte solution, or equine abdominal fat.

The research investigates how the durability, weight, and volume of types of knots (forwarder versus surgeon’s knots), tied with a specific kind of suture, are affected when exposed to different conditions – air, a balanced electrolyte solution (BES), or equine abdominal fat.

Methods

• The study used in vitro methods with a total of 315 knots tied and tested.
• The suture used for the tests was United States Pharmacopeia size-3 polyglactin 910.
• These sutures were exposed to different conditions: air (dry), equine abdominal fat (fat-exposed), or balanced electrolyte solution (BES).
• Using the exposed sutures, forwarder knots with 2, 3, and 4 throws and surgeon’s knots with 5, 6, 7, and 8 throws were tied.
• A universal materials testing machine was utilized to examine the tensile strength of both the suture and the knots until failure.
• The researchers then measured the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of the knots.

Results

• Forwarder knots had a significantly higher KHC and RKS, and lower volume, compared to the surgeon’s knots.
• Forwarder knots tied with sutures that had been exposed to abdominal fat had a higher weight but did not have a greater volume than forwarder knots tied with sutures exposed to dry or BES conditions.

Conclusions

• The forwarder knots performed better than the surgeon’s knots when applied as start knots for continuous suture lines.
• Exposure to different conditions, like equine abdominal fat, dry air, or BES, didn’t negatively impact the mechanical or physical properties of the forwarder knots. Instead, certain biomechanical factors such as KHC and RKS may improve upon exposure to these media.