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. 2016 Apr;80(2):162-70.

Evaluation of the effect of 4 types of knots on the mechanical properties of 4 types of suture material used in small animal practice

Xytilis Avoine  1 , Bertrand Lussier  1 , Vladimir Brailovski  1 , Karine Inaekyan  1 , Guy Beauchamp  1
Affiliations

Evaluation of the effect of 4 types of knots on the mechanical properties of 4 types of suture material used in small animal practice

Xytilis Avoine et al. Can J Vet Res. 2016 Apr.

Abstract
in English, French

The influence of the type of material used, knot configuration, and use of an additional throw on the tensile force at failure, the elongation, and the mode of failure of different configurations of linear sutures and knotted suture loops was evaluated in this in-vitro mechanical study. We hypothesized that all types of knots would significantly influence the initial force and elongation of suture materials and would influence the force and elongation at which the knotted loops break, but not their mode of failure. A total of 432 samples of 4 types of size 3-0 suture material (polydioxanone, polyglecaprone 25, polyglactin 910, and nylon), representing 9 configurations, were tested in a tensiometer. The configurations were 1 linear suture without a knot and the following loops: square (SQ) knot; surgeon's (SU) knot; granny (GR) knot; and sliding half-hitch (SHH) knot using either 4 and 5 or 3 and 4 throws, depending on the material. For polydioxanone, SQ and SU knots did not decrease the initial force at failure of the suture. Granny (GR) and SHH knots decreased the tensile force at failure and elongation by premature failure of the loop. For polyglecaprone 25, all knots decreased the initial force at failure of the suture, with SHH being weaker than the other knots. For coated polyglactin 910, all knots decreased the initial force at failure of the suture and slippage increased significantly compared with the other 3 sutures. The use of SQ knots with 3 throws did not result in a safe knot. For nylon, knots did not alter the original mechanics of the suture. In conclusion, all knots and types of suture material do not necessarily have the same effect on the initial tensile force at failure of suture materials.

L’objectif de la présente étude était de déterminer, dans des conditions expérimentales contrôlées, l’influence de quatre types de noeud, du nombre de croisements et du type de matériel de suture utilisés sur le mode de rupture, l’élongation et la résistance de différentes configurations de boucles de suture. Un total de 432 échantillons de quatre types de fil de suture 3-0 (polydioxanone, polyglecaprone 25, polyglactin 910, nylon), représentant neuf configurations, ont été évalués à l’aide d’un tensiomètre. Plusieurs paramètres ont été analysés: la force atteinte lors de la rupture, l’élongation maximale de la boucle et son mode de rupture. Les différentes configurations sont: suture linéaire, noeud plat (NP), de chirurgien (NC), de vache (NV) et le noeud coulissant barré (NCB) en réalisant 4 et 5 croisements pour les monofilaments et 3 et 4 croisements pour le multifilament. Les différents matériaux et noeuds utilisés n’affectent pas tous de la même manière la force initiale du matériel de suture. Pour le polydioxanone, le NP et NC ne diminuent pas la force initiale du fil de suture. Le NV et le NCB diminuent la force initiale du fil de suture et diminuent son élongation par un bris prématuré du fil de suture. Pour le polyglecaprone 25, tous les noeuds réduisent la force initiale de la suture; le NCB est celui qui affecte le plus le matériel de suture. Pour le polyglactin 910 enrobé, tous les noeuds réduisent la force initiale de la suture; le glissement est augmenté de manière significative comparé aux trois autres types de matériels de sutures, une élongation significative de la boucle de suture a été observée avec la présence d’un NP avec trois croisements. Pour le nylon, les noeuds n’ont pas modifié les propriétés mécaniques d’origine du fil de suture. En conclusion, un NP et NC avec un polydioxanone 3-0 ne diminue pas la force initiale du fil de suture. Le polyglactin 910 enrobé est significativement associé à un glissement accru. Il n’y a pas de différence statistiquement significative à l’ajout d’un croisement à une boucle de suture 3-0.(Traduit par les auteurs).

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Figures

Figure 1
Figure 1
Testing jig of the materials-testing system with a knotted loop of suture positioned between the rods.
Figure 2
Figure 2
Effect of 8 loop configurations on the tensile force Newton (N) at failure of 4 suture materials. All loop configurations are compared to linear suture for each type of suture material. Significant values are indicated by symbol: formula image
Figure 3
Figure 3
Effect of 4 loop configurations on the tensile force (N) at failure of 4 suture materials. Each knot configuration is compared to the other 3 configurations for each type of suture material. The number of throws is 4 for polydioxanone, polyglecaprone 25, and nylon and 3 for coated polyglactin 910.
Figure 4
Figure 4
Effect of 8 loop configurations on the elongation (mm) at failure of 4 suture materials. All knot configurations are compared to linear suture for each type of suture material. Significant values are indicated by symbol: formula image
Figure 5
Figure 5
Effect of 4 loop configurations on the elongation (mm) at failure of 4 suture materials. All knot configurations are compared to each other for each type of suture material. The number of throws is 4 for polydioxanone, polyglecaprone 25, and nylon and 3 for coated polyglactin 910.
Figure 6
Figure 6
Load-displacement curves of coated polyglactin 910. Each line represents a tested suture loop: 12 loops were evaluated per knot configuration. Tensile force (N) versus displacement (mm).
See this image and copyright information in PMC

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