Comparison of Tensile Strength of Slip Knots With That of 3-1-1 Knots Using 10-0 Nylon Sutures

Lutchman, Carla; Leung, Louis M L; Moineddin, Rahim; Chew, Hall F.

doi:10.1097/ico.0000000000000063

Cited by 3 publications

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“…For instance, in one study, the modified slip knot tolerated 0.64 N before breakage and 0.37 N before slippage, whereas the surgeons knot tolerated 0.71 and 0.48 N, respectively. 4 In another study, the slip knot and modified slip knot demonstrated greater than 2 times more slippage after 24 hours than the surgeon's knot. 7 Herein, we present an alternative technique for tying a 3-1-1 square knot, reducing its crosssectional area while burying the knot, thus reducing the likelihood of suture breakage.…”

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confidence: 94%

“…Each of these techniques produces a smaller knot that requires less force when burying. 4,7,8 The slip knot and modified slip knot in particular offer the additional benefit of tension adjustment until after the third throw. The trade-off, however, is that these alternatives produce sutures with reduced tensile strength compared with the traditional 3-1-1 technique.…”

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confidence: 99%

“…The trade-off, however, is that these alternatives produce sutures with reduced tensile strength compared with the traditional 3-1-1 technique. 4,8 In the 3-1-bury-1 technique, the cross-sectional area of the knot is smaller after the second throw than that of the standard 3-1-1 knot. This reduced cross-sectional area allows the knot to be more easily rotated into the corneal stroma.…”

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confidence: 99%

“…3 MEN2B is localized to chromosome 10 and is caused by a defect in the RET (rearranged during tranfection) proto-oncogene. 4 Typical ocular finding of MEN2B is prominent corneal nerves (100%). Other characteristic ocular features include conjunctival and eyelid neuromas (80%À87%), dry eye disease (67%), thickened upper eyelids, and prominent perilimbal blood vessels.…”

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confidence: 99%

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How to knot bury and not break the suture: the 3-1-bury-1 knot

Deveau

Seamone

Lewis

et al. 2019

Canadian Journal of Ophthalmology

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CC. Trauma-induced exacerbation of epithelial-stromal TGFBI lattice corneal dystrophy. Can J Ophthalmol. 2019;54:e47-9. 3. Evans CJ, Davidson AE, Carnt N, et al. Genotype-phenotype correlation for TGFBI corneal dystrophies identifies p.(G623D) as a novel cause of epithelial basement membrane dystrophy. Invest Ophthalmol Vis Sci. 2016;57:5407-14. 4. Yang J, Han X, Huang D, et al. Analysis of TGFBI gene mutations in Chinese patients with corneal dystrophies and review of the literature.

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confidence: 94%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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How to knot bury and not break the suture: the 3-1-bury-1 knot

Deveau

Seamone

Lewis

et al. 2019

Canadian Journal of Ophthalmology

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Biomechanics in Knot Tying

Brzóska¹,

Laprus²,

Michniowski³

et al. 2017

Knots in Orthopedic Surgery

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How to tie dangerous surgical knots: easily. Can we avoid this?

Drabble

Spanopoulou

Sioka³

et al. 2021

BMJ Surg Interv Health Technologies

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ObjectiveSecure knots are essential in all areas of surgical, medical and veterinary practice. Our hypothesis was that technique of formation of each layer of a surgical knot was important to its security.DesignEqual numbers of knots were tied, by each of three groups, using three techniques, for each of four suture materials; a standard flat reef knot (FRK), knots tied under tension (TK) and knots laid without appropriate hand crossing (NHCK). Each knot technique was performed reproducibly, and tested by distraction with increasing force, till each material broke or the knot separated completely.SettingTemporary knot tying laboratory.MaterialsThe suture materials were, 2/0 polyglactin 910 (Vicryl), 3/0 polydioxanone, 4/0 poliglecaprone 25 (Monocryl) and 1 nylon (Ethilon).ParticipantsThree groups comprised, a senior surgeon, a resident surgeon and three medical students.Outcome measuresProportion of each knot type that slipped, degree of slippage and length of suture held in loop secured by each knot type.Results20% of FRK tied with all suture materials slipped; all knots tied with the other two techniques, with all materials, slipped, TK (100%) and NHCK (100%). The quantitative degree of slip was significantly less for FRK (mean 6.3%–, 95% CI 2.2% to 10.4%) than for TK (mean 312%, 95% CI 280.0% to 344.0%) and NHCK (mean 113.0%, –95% CI 94.3% to 131.0%).The mean length of suture in loops held within (FRK mean 25.1 mm 95% CI 24.2 to 26.0 mm) was significantly greater than mean lengths held by the other techniques (TK mean 17.0 mm, 95% CI 16.3 to 17.7 mm), (NHCK mean 16.3 mm, 95% CI 15.9 to 16.7 mm). The latter two types of knot may have tightened more than anticipated, in comparison to FRK, with potential undue tissue tension.ConclusionMeticulous technique of knot tying is essential for secure knots, appropriate tissue tension and the security of anastomoses and haemostasis effected.

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Comparison of Tensile Strength of Slip Knots With That of 3-1-1 Knots Using 10-0 Nylon Sutures

Abstract: In 10-0 nylon sutures, the 3-1-1 knot has a statistically significant greater tensile strength than the slip knot has in conditions wherein they fail by either breakage or unraveling.

Cited by 3 publications

References 4 publications

How to knot bury and not break the suture: the 3-1-bury-1 knot

How to knot bury and not break the suture: the 3-1-bury-1 knot

Biomechanics in Knot Tying

How to tie dangerous surgical knots: easily. Can we avoid this?

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