Surgical knot security

Gupta, B. S. and Postlethwait, R. W., An analysis of surgical knot security in sutures , in Biomaterials 1980 (Winter, Gibbons and Plenk, Eds), John Wiley and Sons, 1982,661-668. 

Herrman, J. B., Tensile strength and knot security of surgical suture materials . Am. Surg., 37,1971,209-217. 

Liver perfusion. Mice are anaesthetized by intraperitoneal injection of pentobarbital (0.07 mg/g bodyweight dilute pentobarbital stock solution 7x with 0.9% NaCl, and inject 0.1 ml/10 g bodyweight). Abdomen is opened, portal vein exposed and loosely tied off with sterile surgical thread. Portal vein is then cannulated with the blunt needle, which is tied securely in place with a knot. Inferior vena... 

Abstract The chapter describes procedures and materials used and results obtained from several important studies of the mechanical performance of surgical sutures and the chnical factors that influence their behavior. Key features of successful suture assembly are the material used, structure of the thread, surface treatment, knot strength, and security, the in vivo environment and compatibihty of the tensile properties of the thread with those of the tissues approximated during and after surgery. To improve suture success in terms, particularly, of knot performance, couphng of thermal and chemical energies in conjunction with mechanical interlacing have been experimented with. 

The changes in tensile properties were evaluated using two commercially available sutures Ethicon surgical silk and Mersilene , both in sizes 1/0, 2/0,3/0, and 4/0. Controlled knots were constructed on the device shown in Fig. 12.1, which also illustrates the principle involved. The suture is looped around two posts, set 2" (5 cm) apart. The first two throws are tied in the middle of the front post one end of the suture is clamped securely while the other is subjected to the required tension. The latter was maintained constant for 5 sec, it was then released, the ends undamped, the next throw tied. 

Good, E. D., Mechanical Analysis of Knot Strength and Security in Polyester and Silk Surgical Sutures , Master s Thesis, College of Textiles, North Carolina State University, Raleigh, North Carolina, 1978. 

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