The half-hitch knot: A rational alternative to the square knot

Gunderson, Paul E.

doi:10.1016/0002-9610(87)90273-x

Cited by 32 publications

(25 citation statements)

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“…Although it has been suggested that square knots and RHAP knots with 1 extra throw have similar strengths and knot security, quantitative comparisons of the strength of the square knot versus the RHAP knot have yet to be established. 11 In the present study we sought to assess whether the RHAP knot with an additional throw could impart equivalent strength to the square knot by examining the tensile breaking strengths and mode of failures of each using an array of suture materials.…”

Section: Discussionmentioning

confidence: 99%

Comparing the tensile strength of square and reversing half-hitch alternating post knots

Sykes

Mercer

et al. 2017

CJS

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Background: Square knots are the gold standard in hand-tie wound closure, but are difficult to reproduce in deep cavities, inadvertently resulting in slipknots. The reversing half-hitch alternating post (RHAP) knot has been suggested as an alternative owing to its nonslip nature and reproducibility in limited spaces. We explored whether the RHAP knot is noninferior to the square knot by assessing tensile strength. Methods:We conducted 10 trials for each baseline and knot configuration, using 3-0 silk and 3-0 polyglactin 910 sutures. We compared tensile strength between knot configurations at the point of knot failure between slippage and breakage.Results: Maximal failure strength (mean ± SD) in square knots was reached with 4-throw in both silk (30 ± 1.5 N) and polyglactin 910 (39 ± 12 N). For RHAP knots, maximal failure strength was reached at 5-throw for both silk (31 ± 1.5 N) and polyglactin 910 (41 ± 13 N). In both sutures, there were no strength differences between 3-throw square and 4-throw RHAP, between 4-throw square and 5-throw RHAP, or between 5-throw square and 6-throw RHAP knots. Polyglactin 910 sutures, in all knot configurations, were more prone to slippage than silk sutures (p < 0.001).

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Section: Discussionmentioning

confidence: 99%

Comparing the tensile strength of square and reversing half-hitch alternating post knots

Sykes

Mercer

et al. 2017

CJS

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“…This weakens the material at the site of these throws. A square knot is tightened by applying tension equally on each suture end in opposite directions of the same plane parallel to the entrance and exit of the basal threads [3]. This can be difficult to perform properly in certain situations and with certain suture materials.…”

Section: Discussionmentioning

confidence: 99%

“…This can be difficult to perform properly in certain situations and with certain suture materials. Even experienced surgeons may actually be forming a slip knot when intending to form a square knot [3,8]. Properly formed square knots can be converted into a series of half-hitches when uneven tension is applied to the suture ends, particularly with monofilament materials [8].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of knot security in continuous intradermal wound closures

Richey

Roe

2005

Journal of Surgical Research

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“…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].…”

Section: Introductionmentioning

confidence: 99%