Square Not a Running Knot

Aanning, H L; Haas, Tara L.; Jorgensen, David R.; Wulf, Corey A.

doi:10.1016/j.jamcollsurg.2006.12.024

Cited by 16 publications

(10 citation statements)

References 6 publications

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“…However, recent studies on monofilament sutures have demonstrated that flat knots assume a sliding conformation when held under unequal tension [21]. This in turn generates stress on the suture, which breaks precisely at the point at which the configuration of the knot changes [22,23]. Using a sliding knot on monofilament suture materials avoid the risk of changes in knot configuration, thus increasing ligature safety.…”

Section: Discussionmentioning

confidence: 99%

Ex vivo comparison of the giant and transfixing knot in equine open and closed castration

Comino

Giusto

Caramello

et al. 2016

Equine Veterinary Journal

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The giant and transfixing knot techniques have comparable haemostatic capability and parietal tunic tensile strength, but the giant knot requires less suture material. In open castration, using the emasculator alone may produce adequate haemostasis. In closed castration, using the giant knot in combination with the emasculator increases the bursting pressure and possibly reduces the incidence of haemorrhage. In closed castration, application of a ligature may reduce the risk of evisceration.

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Section: Discussionmentioning

confidence: 99%

Ex vivo comparison of the giant and transfixing knot in equine open and closed castration

Comino

Giusto

Caramello

et al. 2016

Equine Veterinary Journal

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“…As the results reported in the literature are not standardized and not easily comparable [28], the technique options presented tend to confuse rather than help the surgical community [29,30]. This might be one of the reasons why some authors doubt that scientific evidence could persuade surgeons to change their technique [5].…”

Section: Introductionmentioning

confidence: 99%

“…In order to establish the safety characteristics of different suture materials and the corresponding knot tying techniques, many authors used technical devices and even electron microscopy [6,7,15,30,[38][39][40]. These devices, it is true, provided solid information on issues such as breaking strength and slippage, but the translation of such findings into clinical application is problematic.…”

Section: Introductionmentioning

confidence: 99%

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

Fischer

Brückner

Müller‐Stich

et al. 2009

Langenbecks Arch Surg

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“…They found no slippage in chain-stitch knots, again similar to our findings with a hybrid knot. Aanning et al found that a running polypropylene suture anchored with half hitches was stronger than a running suture tied with square knots [4]. Gunderson found that half-hitch knots were as secure as square knots and easier to tie [5].…”

Section: Discussionmentioning

confidence: 99%

Surgical Knot Strength in Continuous Wound Closures

Nigliazzo¹,

Arrangoiz²,

Hutchison³

et al. 2011

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Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04; sliding 10.72 +/– 1.35; and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%; sliding 83.4%; hybrid 85.2%. Significant dif-ferences (p < 0.0001) in KHC exist between square and sliding knots (favoring sliding knots) and between square and hybrid knots (favoring hybrid knots). Hybrid and sliding knots were not statistically different. Conclusion: Sliding knots and hybrid knots are superior to square knots as anchoring knots for single-strand continuous wound closure

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Square Not a Running Knot

Cited by 16 publications

References 6 publications

Ex vivo comparison of the giant and transfixing knot in equine open and closed castration

Ex vivo comparison of the giant and transfixing knot in equine open and closed castration

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

Surgical Knot Strength in Continuous Wound Closures

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