Effect of Diameter and Type of Suture on Knot and Loop Security
The loop and knot securities of two polyfilament and two monofilament sutures of four diameters (3.0, 2.0, 0, 1) were evaluated with a tensiometer for four four-throw knots, known to be secure with a 2.0 polyfilament suture. Loop security of Monocryl 1 is low, being 14.7 ± 3.0 Newton (N) for a three...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/19/6418 |
| _version_ | 1797575603269926912 |
|---|---|
| author | Armando Romeo Christiane Fujimoto Isabella Cipullo Mauricio Giarola Chiara Benedetto William Kondo Bedayah Amro Anastasia Ussia Arnaud Wattiez Philippe R. Koninckx |
| author_facet | Armando Romeo Christiane Fujimoto Isabella Cipullo Mauricio Giarola Chiara Benedetto William Kondo Bedayah Amro Anastasia Ussia Arnaud Wattiez Philippe R. Koninckx |
| author_sort | Armando Romeo |
| collection | DOAJ |
| description | The loop and knot securities of two polyfilament and two monofilament sutures of four diameters (3.0, 2.0, 0, 1) were evaluated with a tensiometer for four four-throw knots, known to be secure with a 2.0 polyfilament suture. Loop security of Monocryl 1 is low, being 14.7 ± 3.0 Newton (N) for a three-throw half-knot (H3) and 15.4 ± 2.4 N and 28.3 ± 10 N for two (SSs) and four (SSsSsSs) symmetrical sliding half-hitches. This is lower than 18, 24, and 46 N for similar knots with Vicryl. Polyfilament sutures have excellent knot security for all four diameters. Occasionally, some slide open with slightly lower knot security, especially for larger diameters, although this is not clinically problematic. Knot security of monofilament sutures was unpredictable for all four knots, especially for larger diameters, resulting in many clinically insecure knots. A secure monofilament knot requires a six-throw knot with two symmetrical sliding half-hitches or two symmetrical half-knots secured with four asymmetric blocking half-hitches. In conclusion, with polyfilament sutures, four- or five-throw half-knot or half-hitch sequences result in secure knots. For monofilament sutures, loop and knot security is much less, half-knot combinations should be avoided, and secure knots require six-throw knots with four asymmetric blocking half-hitches. |
| first_indexed | 2024-03-10T21:41:47Z |
| format | Article |
| id | doaj.art-73279463b8104306b476c6e7cf8fd35b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:41:47Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-73279463b8104306b476c6e7cf8fd35b2023-11-19T14:38:30ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011219641810.3390/jcm12196418Effect of Diameter and Type of Suture on Knot and Loop SecurityArmando Romeo0Christiane Fujimoto1Isabella Cipullo2Mauricio Giarola3Chiara Benedetto4William Kondo5Bedayah Amro6Anastasia Ussia7Arnaud Wattiez8Philippe R. Koninckx9Research Educational Center, University of Turin, 10124 Turin, ItalyDepartment of OBGYN, Faculty of Medicine, University of Santa Casa di Sao Paulo, Sao Paulo 05508-220, BrazilDepartment Obstetrics and Gynecology, Ospedale Regina Montis Regalis di Mondovìn, 12084 Turin, ItalyDepartment of OBGYN, Faculty of Medicine, S.Anna Hospital Torino, 10126 Turin, ItalyDepartment Obstetrics and Gynecology, Ospedale Regina Montis Regalis di Mondovìn, 12084 Turin, ItalyCentro Avançado de Cirurgia Ginecológica, Department of OBGYN, Faculty of Medicine, Curitiba 81020-430, BrazilDepartment of OBGYN, Faculty of Medicine, Latifa Hospital, Dubai 9115, United Arab EmiratesDepartment of OBGYN, Faculty of Medicine, Ucatholic University and Gruppo Italo Belga, Villa Del Rosario, 00168 Rome, ItalyDepartment of OBGYN, Faculty of Medicine, Latifa Hospital, Dubai 9115, United Arab EmiratesDepartment of OBGYN, Faculty of Medicine, Latifa Hospital, Dubai 9115, United Arab EmiratesThe loop and knot securities of two polyfilament and two monofilament sutures of four diameters (3.0, 2.0, 0, 1) were evaluated with a tensiometer for four four-throw knots, known to be secure with a 2.0 polyfilament suture. Loop security of Monocryl 1 is low, being 14.7 ± 3.0 Newton (N) for a three-throw half-knot (H3) and 15.4 ± 2.4 N and 28.3 ± 10 N for two (SSs) and four (SSsSsSs) symmetrical sliding half-hitches. This is lower than 18, 24, and 46 N for similar knots with Vicryl. Polyfilament sutures have excellent knot security for all four diameters. Occasionally, some slide open with slightly lower knot security, especially for larger diameters, although this is not clinically problematic. Knot security of monofilament sutures was unpredictable for all four knots, especially for larger diameters, resulting in many clinically insecure knots. A secure monofilament knot requires a six-throw knot with two symmetrical sliding half-hitches or two symmetrical half-knots secured with four asymmetric blocking half-hitches. In conclusion, with polyfilament sutures, four- or five-throw half-knot or half-hitch sequences result in secure knots. For monofilament sutures, loop and knot security is much less, half-knot combinations should be avoided, and secure knots require six-throw knots with four asymmetric blocking half-hitches.https://www.mdpi.com/2077-0383/12/19/6418knot sequenceshalf-knotshalf-hitchesknot rotationknot securityloop security |
| spellingShingle | Armando Romeo Christiane Fujimoto Isabella Cipullo Mauricio Giarola Chiara Benedetto William Kondo Bedayah Amro Anastasia Ussia Arnaud Wattiez Philippe R. Koninckx Effect of Diameter and Type of Suture on Knot and Loop Security Journal of Clinical Medicine knot sequences half-knots half-hitches knot rotation knot security loop security |
| title | Effect of Diameter and Type of Suture on Knot and Loop Security |
| title_full | Effect of Diameter and Type of Suture on Knot and Loop Security |
| title_fullStr | Effect of Diameter and Type of Suture on Knot and Loop Security |
| title_full_unstemmed | Effect of Diameter and Type of Suture on Knot and Loop Security |
| title_short | Effect of Diameter and Type of Suture on Knot and Loop Security |
| title_sort | effect of diameter and type of suture on knot and loop security |
| topic | knot sequences half-knots half-hitches knot rotation knot security loop security |
| url | https://www.mdpi.com/2077-0383/12/19/6418 |
| work_keys_str_mv | AT armandoromeo effectofdiameterandtypeofsutureonknotandloopsecurity AT christianefujimoto effectofdiameterandtypeofsutureonknotandloopsecurity AT isabellacipullo effectofdiameterandtypeofsutureonknotandloopsecurity AT mauriciogiarola effectofdiameterandtypeofsutureonknotandloopsecurity AT chiarabenedetto effectofdiameterandtypeofsutureonknotandloopsecurity AT williamkondo effectofdiameterandtypeofsutureonknotandloopsecurity AT bedayahamro effectofdiameterandtypeofsutureonknotandloopsecurity AT anastasiaussia effectofdiameterandtypeofsutureonknotandloopsecurity AT arnaudwattiez effectofdiameterandtypeofsutureonknotandloopsecurity AT philipperkoninckx effectofdiameterandtypeofsutureonknotandloopsecurity |