Knot properties of alternating sliding knots with different patterns in comparison to alternating and simple sliding knots.

This study attempts to compare the alternating sliding knots with different patterns with the alternating and simple sliding knots. Silk and nylon sutures of 2-0 and 4-0 United States Pharmacopeia (USP) sizes were mechanically tested. The values of knot holding capacities (KHCs) varied depending on knot configuration, suture material, and size. The parallel alternating knot with different patterns showed a high KHC for silk suture of both sizes. For nylon, the alternating knots with different patterns were comparable to the simple sliding knots. When we compared silk with nylon in knots with different patterns we observed the following. For size 2-0 loops, the nonidentical knot of nylon was higher in KHC than that of silk, and the parallel knot of silk was higher in KHC than that of nylon. Loops of 4-0 showed higher KHCs for the parallel knot in nylon than in silk but similar values for both materials with the nonidentical knot. The parallel alternating knot with different patterns was the most efficient for nylon 4-0. The silk loops had good efficiencies for both sizes. The silk suture knots were all reliable. The nylon suture showed unreliability for the parallel and alternating nonidentical knots of both sizes and the alternating parallel knot in 2-0 suture. The results section discusses the physical structure and suture dimension. This study did not prove that the strength of the knot increases with complexity.