Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures

Türker, Mehmet; Yalçınozan, Mehmet; Çirpar, Meriç; Cetik, Ozgur; Kalaycıoğlu, Barış

doi:10.1007/s00167-012-1882-0

Cited by 6 publications

(11 citation statements)

References 11 publications

(28 reference statements)

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“…One possible explanation could be random error due to, for instance, the quality of the underlying initial two knots, though the effect of such errors should have been eliminated considering the 60 trials performed in the study (p = 0.01). On the other hand, similar findings have also been reported in literature, where the knot quality does not appear to be the function of a sole variable consisting of magnitude of the pulling force [51], [52]. Hence, the underlying reason for this observation may lie in the way the suture's structure fails under excessive load.…”

Section: Discussionsupporting

confidence: 85%

Suture Breakage Warning System for Robotic Surgery

Abiri

Askari²,

Tao³

et al. 2019

IEEE Trans. Biomed. Eng.

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As robotic surgery has increased in popularity, the lack of haptic feedback has become a growing issue due to the application of excessive forces that may lead to clinical problems such as intraoperative and postoperative suture breakage. Previous suture breakage warning systems have largely depended on visual and/or auditory feedback modalities, which have been shown to increase cognitive load and reduce operator performance. This work catalogues a new sensing technology and haptic feedback system (HFS) that can reduce instances of suture failure without negatively impacting performance outcomes including knot quality. Suture breakage is common in

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Section: Discussionsupporting

confidence: 85%

Suture Breakage Warning System for Robotic Surgery

Abiri

Askari²,

Tao³

et al. 2019

IEEE Trans. Biomed. Eng.

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“…When we are confronted with a high-tension closure, the usual practice is clamping the first throw with the help of an assistant. The results of Mehmet's research demonstrated that the ultimate failure load of the monofilament nonabsorbable polypropylene suture was significantly decreased when the first throw was fixed with a clamp to prevent slippage; however, monofilament polyglyconate, nylon, and braided absorbable polyglactin sutures were not affected by fixing the first throw (5). According to Bisson's study, the UTL was reduced in No.…”

Section: Discussionmentioning

confidence: 99%

“…However, this usual practice has certain deficiencies. First, clamp fixation to prevent unfolding of the first suture knot may damage the suture and decrease its tensile strength (5)(6)(7)(8). Second, the first suture knot may slide leading to a small Original Article gap formation when the clamp is removed.…”

Section: Introductionmentioning

confidence: 99%

A novel and efficient surgical knotting technique for high-tension closures

Chang

Wang

et al. 2021

Ann Transl Med

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Background: The closure of high-tension incisions without any assistance can be difficult and challenging for surgeons. A common practice is to fix the first knot with a clamp and then tie a reverse locking knot; however, this practice has certain disadvantages. The aim of this study was to introduce a novel and efficient surgical knotting technique with various advantages. Methods:The two knotting methods used in this study were the absorbable braided suture where the first suture was fixed with a clamp (with assistance) and the SH-9Hospital knotting technique (without assistance) applied on the smooth surface of a cylinder. Mechanical testing was performed using a universal material testing machine. The load-elongation curve and ultimate tensile load (UTL) were recorded. Results:The mean knotting time was 36.40±1.50 s (range, 32-41 s) and 24.80±1.16 s (range, 21-28 s) in the clamp and SH-9Hosptial groups, respectively. The mean UTL was 120.8±10.14 N (range, 81.11-136.55 N) and 126.5±6.29 N (range, 104.88-139.56 N) in the clamp and SH-9Hospital groups, respectively. The knot strength of the SH-9Hospital technique was not inferior to traditional clinical practice. Conclusions:The SH-9Hospital knotting technique was a secure, convenient, and efficient method for high-tension closure.

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“…The crimp generates friction on the leader line, increasing load and stiffness while decreasing elongation . The interface where the nylon exits the crimp clamp is a vulnerable point due to the stress riser effect, similar to a knot . The use of double‐loops and double‐crimp clamps has also been recommended for enhanced strength of repair …”

mentioning

confidence: 99%

“…When making a square knot, the practice of clamping the first throw with an instrument to prevent loss of tension can damage the material and reduce its tensile strength. Turker et al reported that polypropylene had significantly lower ultimate failure load when the first throw was clamped; however, nylon was not affected by fixing the first throw . The tube knot (TB; Figs and ) is a low‐profile, flat knot made using a large gauge, preferably blunt, hypodermic needle to act as the tube, and is based on a fly fishing knot known as the nail knot (http://www.netknots.com/fishing_knots/nail-knot/).…”

mentioning

confidence: 99%