Dogny Clélia L, Laedermann Jeremy, La Scala Giorgio C
From the Pediatric Plastic Surgery, Division of Pediatric Surgery, Department of Pediatrics, University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Geneva, Switzerland.
Wyss Center for Bio and Neuroengineering, Geneva, Switzerland.
Plast Reconstr Surg Glob Open. 2025 Jul 18;13(7):e6921. doi: 10.1097/GOX.0000000000006921. eCollection 2025 Jul.
Surgical knot security is essential to preventing complications such as knot failure or tissue tearing. The number of throws and the use of surgeon's knots influence knot strength; thus, this study aimed to evaluate the impact of throws and surgeon's knots on the tensile strength and loop elongation of Vicryl and Prolene 5-0 sutures.
Vicryl and Prolene 5-0 sutures were tied in knots of 3, 4, and 5 throws, across 12 different knot sequences: single knots only, surgeon's knots only, and an increasing number of surgeon's knots. Samples were tested using a tensiometer applying a constant force until knot failure or slippage.
The tensile strength of the knots increased significantly with the number of throws and the presence of surgeon's knots ( < 0.005). Five-throw knots were stronger than 3-throw knots regardless of the number of surgeon's knots for both types of sutures. The use of surgeon's knots only significantly increased strength in the 3-throw series for both Prolene and Vicryl sutures. For both sutures, a 3-throw surgeon's knot showed the same tensile strength as a 5-throw simple knot. Loop elongation depended on the number of throws and surgeon's knots.
The use of surgeon's knots alone increased a knot's breaking resistance without the need for additional simple throws. A 3-throw surgeon's knot provides breaking resistance equivalent to a knot with more throws. If reduced loop elongation is desired, the choices would be 4 surgeon's throws for Vicryl and 5 simple throws for Prolene.
手术结的安全性对于预防诸如结松开或组织撕裂等并发症至关重要。打结的次数以及方结的使用会影响结的强度；因此，本研究旨在评估打结次数和方结对维可牢尼龙缝线和聚丙烯5-0缝线的抗张强度及线圈伸长的影响。
将维可牢尼龙缝线和聚丙烯5-0缝线打成3次、4次和5次的结，共有12种不同的打结顺序：仅单结、仅方结以及方结数量增加的情况。使用张力计对样本施加恒定力直至结松开或滑脱进行测试。
结的抗张强度随着打结次数和方结的存在而显著增加（<0.005）。对于两种类型的缝线，无论方结的数量如何，5次打结的结都比3次打结的结更强。仅使用方结在聚丙烯和维可牢尼龙缝线的3次打结系列中显著提高了强度。对于两种缝线，一个3次打结的方结与一个5次打结的单结具有相同的抗张强度。线圈伸长取决于打结次数和方结。
仅使用方结可增加结的抗断裂性，而无需额外的单结。一个3次打结的方结提供的抗断裂性等同于打结次数更多的结。如果希望减少线圈伸长，对于维可牢尼龙缝线的选择是4次方结，对于聚丙烯缝线的选择是5次单结。
