At DongGuk University International Hospital, DongGuk University School of Medicine, Seoul, South Korea, SooA Lim, MD, PhD, is Associate Professor, Department of Plastic and Reconstructive Surgery; Dong Yun Lee, MD, is Chief Resident, Department of Plastic and Reconstructive Surgery; GyeongHyeon Doh, MD, is Resident, Department of Plastic and Reconstructive Surgery; YeongKwon Seo, PhD, is Professor, Department of Biosystems; ChiYeon Lim, PhD, is Professor, Department of Statistics; JungSoo Yoon, MD, PhD, is Assistant Professor, Department of Plastic and Reconstructive Surgery; and SuRak Eo, MD, PhD is Professor, Department of Plastic and Reconstructive Surgery.
Adv Skin Wound Care. 2024 Jul 1;37(7):354-359. doi: 10.1097/ASW.0000000000000123. Epub 2024 Apr 10.
To evaluate the strengths of various surgical knot techniques, including square knot, surgeon's knot, granny knot, and random knot with the same three throws.
The authors tested each of the four knot techniques using four different gauges of nylon (polyamide [Ethicon]): 4-0, 5-0, 6-0, and 7-0. Each knot type was tested 20 times per nylon gauge, for a total of 320 knots tested. The authors used a static pull machine to measure elongation at yield and maximal force to break.
A comparison of elongation at yield revealed that the surgeon's knot was superior to the square knot, granny knot, and random knots across all gauges of nylons. Further, a comparison of maximal force to break revealed that the surgeon's knot was superior to the square knot, granny knot, and random knots when using 4-0, 5-0, and 6-0 nylon but not when using 7-0 nylon.
The surgeon's knot was the strongest, and random knot was the weakest when the authors used nylon 4-0, 5-0, and 6-0. While handling fine suture materials such as 7-0 nylon, knot failure appears to be unrelated to the knot technique used. This study provides not only fundamental guidance for tying surgical knots using nylon, but also a rational basis for an adequately strong knot choice in various fields of surgery.
评估各种手术结技术的优势，包括方结、外科结、祖母结和随机结，均采用相同的三抛法。
作者使用四种不同规格的尼龙线（聚酰胺[爱惜康]）：4-0、5-0、6-0 和 7-0 来测试这四种结技术。每种结类型在每种尼龙规格下测试 20 次，总共测试了 320 个结。作者使用静态拉力机测量屈服时的伸长率和最大断裂力。
与方结、祖母结和随机结相比，在所有尼龙规格下，外科结的屈服伸长率都更高。进一步比较最大断裂力，发现外科结在使用 4-0、5-0 和 6-0 尼龙时优于方结、祖母结和随机结，但在使用 7-0 尼龙时则不然。
在使用 4-0、5-0 和 6-0 尼龙时，外科结最强，随机结最弱。而在处理 7-0 尼龙等精细缝线材料时，结的失效似乎与所使用的结技术无关。本研究不仅为使用尼龙结扎手术提供了基本指导，也为外科各个领域选择足够强度的结提供了合理依据。
