The Effect of Instrumentation on Suture Tensile Strength and Knot Pullout Strength of Common Suture Materials

Johnson, Peter C.; Roberts, Aaron; Hire, Justin M.; Mueller, Terry

doi:10.1016/j.jsurg.2015.08.011

Cited by 9 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A specific wound needs certain time to be healed, the suture should maintain enough strength to prevent the wound cracking or separating [38,39]. Therefore, the mechanical property was a vital requirement for PLA-base suture in the process of degradation.…”

Section: Resultsmentioning

confidence: 99%

Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture

Liu

Chen

et al. 2019

Polymers

View full text Add to dashboard Cite

Poly(lactic acid) (PLA) suture can be absorbed by the human body, and so have wide applications in modern surgery operations. The degradation period of PLA suture is expected to meet with the healing time of different types of wounds. In order to control the degradation period of the PLA suture, the carbon nanotubes (CNTs) were composited with PLA suture, and the degradation experiment in vitro was performed on sutures. The structure and properties of sutures during degradation, such as surface morphology, breaking strength, elongation, mass and chemical structure, were tracked and analyzed. The results indicated that the degradation brought about surface defects and resulted in 13.5 weeks for the strength valid time of the original PLA suture. By contrast, the strength valid time of the CNTs/PLA suture was increased to 26.6 weeks. Whilst the toughness of both the pure PLA and CNTs/PLA sutures decreased rapidly and almost disappeared after 3 to 4 weeks of degradation. The mass loss demonstrated that the time required for complete degradation of the two sutures was obviously different, the pure PLA suture 49 weeks, while CNTs/PLA sutures 63 to 73 weeks. The research proved that CNTs delayed PLA degradation and prolonged its strength valid time in degradation.

show abstract

Section: Resultsmentioning

confidence: 99%

Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture

Liu

Chen

et al. 2019

Polymers

View full text Add to dashboard Cite

show abstract

“…Although the exact mechanisms remain largely unclear, various factors from production and packaging process to intraoperative handling may cause or contribute to the breakage or fracture of polypropylene sutures after cardiovascular surgery ( 24 , 25 , 29 ). In an analysis of suture fracture morphology, Karaca and Hockenberber found that the polymer type, size of suture, and knot security played important roles in the breaking process ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

BioGlue® is not associated with polypropylene suture breakage after aortic surgery

Pacini

Murana

Hollinworth³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

ObjectiveWe have encountered broken or damaged polypropylene sutures (Prolene®) at the anastomotic sites during aortic reoperations. Because a surgical sealant, bovine serum albumin-glutaraldehyde (BioGlue®), was used in previous aortic surgery in some of these cases, we undertook this in vitro study to evaluate whether the use of BioGlue® was associated with breakage of polypropylene sutures at the aortic anastomosis.Materials and methodsThe broken polypropylene sutures, anastomotic sites and aortic tissue at the location of suture breakage were visually inspected and evaluated intraoperatively. Six human cadaveric aortic samples were incised circumferentially and anastomosed proximally to a valved conduit with running 4–0 polypropylene sutures (Prolene®). In the test group (n = 3), BioGlue® was applied directly to the Prolene® sutures at the anastomotic sites, while in the control group (n = 3) the anastomoses were not sealed with any surgical adhesive. The six samples were immersed in Dulbecco's phosphate buffered saline solution and mounted on a M-6 Six Position Heart Valve Durability Testing System and tested up to 120 million cycles for a 2-year period. During and upon completion of the testing, the integrity of Prolene® sutures, the anastomosis and aortic tissues was regularly assessed by visual inspection.ResultsIntraoperative findings included a stretched and thin aortic wall (some with thrombus), a small cleft between the aortic tissue and the Dacron vascular graft. An excessive amount of BioGlue® was often found around the anastomosis, with cracking material, but no signs of mechanical damage were observed in these cases. Upon visual inspection during and after in vitro testing, there was no apparent damage to the polypropylene sutures on the interior or exterior of the aortic anastomoses in any of the samples. No difference was observed in the physical integrity of the polypropylene sutures at anastomotic lines, the anastomoses and aortic tissues between the test and control samples.ConclusionsThe results of this study suggest that the use of BioGlue® was not associated with breakage of the polypropylene sutures at the anastomotic sites after aortic dissection repair.

show abstract

“…64,85 Although Johnson et al found no difference, several studies determined that clamped monofilament sutures are damaged more than clamped multifilaments. 4,47,64,86 One study reported a reduction of 10% breaking strength if an SU knot was formed from a clamped monofilament. Clamping for only 15 seconds also markedly reduced the strength in monofilament nylon.…”

Section: Instrumentation and Handlingmentioning

confidence: 99%

Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length

Bushong,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Knots are the weakest structural point in a suture line and inevitably weaken almost all suture materials. This practical review critically evaluates the factors, such as suture material properties, gauge, configuration, throw count, and tail length, that affect knot security. Methods: A PubMed search between the years 1934 and 2023 identified relevant studies that addressed factors relating to knot security. Studies that investigated knots and sutures solely used in laparoscopic and arthroscopic surgery were excluded. Knot configurations assessed were the Aberdeen, sliding, square, and surgeon’s. Results: Eighty-six articles were included in this review article and demonstrated that knot security varies greatly between suture materials and gauge. Knot security also varies by configuration, throw count, conditions, tail length, and stitch type. Throw count differs by knot configuration, with the Aberdeen knot being most secure with three throws and one to two turns compared with three to five throws for surgeon’s and square knots. The optimal tail length was 3 mm. Conclusions: This practical review demonstrates that there are significant differences in knot security based on a variety of factors. It is challenging to propose an ideal knot because most studies did not evaluate knot security using a broad variety of suture materials, gauges, and throws for each of the most common knots. Although this review article demonstrated several applicable findings, additional robust studies are needed to simplify proposals.

show abstract

The Effect of Instrumentation on Suture Tensile Strength and Knot Pullout Strength of Common Suture Materials

Cited by 9 publications

References 5 publications

Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture

Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture

BioGlue® is not associated with polypropylene suture breakage after aortic surgery

Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length

Contact Info

Product

Resources

About