Journal of Surgical Education
Volume 66, Issue 5 , Pages 276-280 , September 2009

Suture End Length as a Function of Knot Integrity

  • Tyler M. Muffly, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio
    • Corresponding Author InformationCorrespondence: Inquiries to Tyler M. Muffly, MD, Center of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, A-81, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; fax: (216) 636-2620
    • ,
  • Christopher Cook, DO

      Affiliations

    • Department of Obstetrics and Gynecology, University of Missouri—Kansas City, Kansas City, Missouri
    • ,
  • Jennifer Distasio, BA

      Affiliations

    • Department of Obstetrics and Gynecology, University of Missouri—Kansas City, Kansas City, Missouri
    • ,
  • Aaron J. Bonham, MSc

      Affiliations

    • Office for Health Services and Public Health Outcomes Research, University of Missouri—Kansas City, Kansas City, Missouri
    • ,
  • Roberta E. Blandon, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Missouri—Kansas City, Kansas City, Missouri
    • Saint Luke's Hospital of Kansas City, Kansas City, Missouri

References 

  1. Batra EK, Franz DA, Towler MA, et al. Influence of surgeon's tying technique on knot security. J Appl Biomater. 1993;4:241–247
  2. Behm T, Unger JB, Ivy JJ, Mukherjee D. Flat square knots: are 3 throws enough?. Am J Obstet Gynecol. 2007;197:172.e1–172.e3
  3. Cumberland VH. A preliminary report on the use of prefabricated nylon weave in the repair of ventral hernia. Med J Aust. 1952;1:143–144
  4. Dunn DL. Wound Closure Manual. Somerville, NJ: Ethicon Inc; 2007;
  5. Rodeheaver GT, Thacker JG, Edlich RF. Mechanical performance of polyglycolic acid and polyglactin 910 synthetic absorbable sutures. Surg Gynecol Obstet. 1981;153:835–841
  6. Pieters P, Tisnado J, Mauro MA. Venous Catheters: A Practical Manual. New York: Thieme Medical Publishers, Inc; 2002;
  7. Everett WG. Suture materials in general surgery. Prog Surg. 1970;8:14–37
  8. Nirankari VS, Karesh JW, Richards RD. Complications of exposed monofilament sutures. Am J Ophthalmol. 1983;95:515–519
  9. Reynolds A. Femoral nerve injury. J Neurosurg. 1983;58:459
  10. Al Khudair W, Abu-Rromeh S, Mansi MK, Huraib S. An unusual cause of recurrent bacteriuria in a kidney transplant recipient. Saudi J Kidney Dis Transpl. 1996;7:398–400
  11. Kadirkamanathan SS, Shelton JC, Hepworth CC, Laufer JG, Swain CP. A comparison of the strength of knots tied by hand and at laparoscopy. J Am Coll Surg. 1996;182:46–54
  12. Schubert DC, Unger JB, Mukherjee D, Perrone JF. Mechanical performance of knots using braided and monofilament absorbable sutures. Am J Obstet Gynecol. 2002;187:1438–1440; Discussion:1441-1442.
  13. Thacker JG, Rodeheaver G, Moore JW, et al. Mechanical performance of surgical sutures. Am J Surg. 1975;130:374–380
  14. Zimmer CA, Thacker JG, Powell DM, et al. Influence of knot configuration and tying technique on the mechanical performance of sutures. J Emerg Med. 1991;9:107–113
  15. Gerten KA, Richter HE, Wheeler TL, et al. Intraabdominal pressure changes associated with lifting: implications for postoperative activity restrictions. Am J Obstet Gynecol. 2008;198:306.e1–306.e5
  16. Nout E, Lange JF, Salu NE, et al. Creep behavior of commonly used suture materials in abdominal wall surgery. J Surg Res. 2007;138:51–55
  17. Mens J, Hoek van Dijke G, Pool-Goudzwaard A, van der Hulst V, Stam H. Possible harmful effects of high intra-abdominal pressure on the pelvic girdle. J Biomech. 2006;39:627–635

 Supported in part by a research grant from the Saint Luke's Hospital Foundation and by donated suture material from Ethicon, Inc.

PII: S1931-7204(09)00161-5

doi: 10.1016/j.jsurg.2009.10.003

Journal of Surgical Education
Volume 66, Issue 5 , Pages 276-280 , September 2009

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