Assessment of knot security in continuous intradermal wound closures

Variability of surgical knot tying techniques: do we need to standardize?

“…The most common types of knots are square and sliding knots [5,6] with, however, many adaptations and modifications and different terminologies [1,[7][8][9][10][11][12][13][14][15]. Taken into account all possible variations, including one-handed, two-handed, and instrument knot tying techniques, it seems that surgeons have almost limitless options [14].…”

“…On the other hand, it has been shown that suture size contributes significantly more to knot volume than to the number of throws [5]. Some authors find that three throws are necessary to avoid knot failure, others recommend four to six throws and still, others report a near zero knot failure rate with six square knots [13,15,40,43,44].…”

Comparison of volume, security, and biomechanical strength of square and Aberdeen termination knots tied with 4–0 polyglyconate and used for termination of intradermal closures in canine cadavers

“…12 Excessive foreign material buried in the tissues can cause inflammation, delays in wound healing, increased probability of infection, and patient discomfort. 4,11,13,[16][17][18] It has been advocated for use in intradermal closures because of these characteristics [19][20][21][22][23] and has also been routinely used in simple continuous wound closures, vascular closures, and intestinal anastomoses. Intradermal closure is a commonly used technique in veterinary surgery, particularly for elective procedures such as castration and ovariohysterectomy.…”

“…We intended to build on a study by Richey and Roe,23 which found that the 2 + 1 Aberdeen knot is as secure as the traditionally used 4-throw square knot when used for termination of a continuous intradermal wound closure. We intended to build on a study by Richey and Roe,23 which found that the 2 + 1 Aberdeen knot is as secure as the traditionally used 4-throw square knot when used for termination of a continuous intradermal wound closure.…”

In Vivo Knot Scoring Model for a Multifilament Suture

“…17,21,22 The purpose of this study is to provide a method to evaluate the knot safety of new sutures on a routine basis.…”