Gil Santos Luis, Más-Estellés Jorge, Salmerón Sánchez Manuel, Barrios Carlos
Centro de Biomateriales e Ingeniería Tisular, Universidad Politécnica de Valencia, España.
Cir Esp. 2012 Jun-Jul;90(6):388-93. doi: 10.1016/j.ciresp.2012.02.001. Epub 2012 Apr 10.
To experimentally study the behaviour of 4 types of monofilament with 3 knotting techniques, very often used in surgery, employing mechanical tests.
Four 4/0 monofilaments were chosen, two of nylon, and the other two of polypropylene. Three types of knot designs were made with each thread. The first design (D-S-S) consisted of a double half-knot (D) followed by one single (S) in the opposite direction, a third S in turn in the opposite direction. The configuration of the second design was D-S-D, and the third, S-S-D. A mechanical fracture test was performed by stretching the thread at a rate of 4N/s, the force and deformation being recorded at intervals of 100 ms.
There was a decrease in the force and deformation in the tests on threads with knots compared to threads without knots. In all cases the rupture of the thread occurred in the knot area, presumably due to damage caused to the thread during the knotting process. The D-S-D knot had the greatest resistance with polypropylene threads, and S-S-D provided the greatest resistance with nylon threads
Polypropylene threads, with D-S-D knots, should be more indicated to suture tissues that have to support great forces and with little deformation of the suture (e.g., tendons). Nylon threads, with S-S-D knots, would be better indicated for tissues that have to support smaller forces and that require greater elasticity (e.g., skin).
通过机械测试，对手术中常用的4种单丝和3种打结技术的性能进行实验研究。
选用4根4/0单丝，其中两根为尼龙材质，另外两根为聚丙烯材质。每种线制作三种打结设计。第一种设计（D-S-S）由一个双半结（D）组成，随后在相反方向打一个单结（S），再在相反方向打第三个单结S。第二种设计的构型为D-S-D，第三种为S-S-D。通过以4N/s的速率拉伸线进行机械断裂测试，每隔100ms记录力和变形。
与未打结的线相比，打结线测试中的力和变形有所降低。在所有情况下，线的断裂都发生在结区域，可能是由于打结过程中线受到的损伤。D-S-D结在聚丙烯线中具有最大的阻力，而S-S-D结在尼龙线中提供最大的阻力。
带有D-S-D结的聚丙烯线，更适合用于缝合需要承受较大力量且缝合处变形较小的组织（如肌腱）。带有S-S-D结的尼龙线，更适合用于需要承受较小力量且需要更大弹性的组织（如皮肤）。
