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Surgery Today

28-09-2024 | Original Article

Comparative strength of ligature points achieved by various surgical knot-tying techniques: an observational study using Maxon™ monofilament sutures

Authors: Shoichi Tsuzaka, Yuji Konishi, Kazuhiro Mino, Naotake Honma, Hideki Kawamura, Takuto Yoshida, Akinobu Taketomi

Published in: Surgery Today

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Abstract

Purpose

Surgical knot-tying requires careful selection of the appropriate technique for optimal outcomes; however, evidence is lacking about the common ligation techniques combining square and slip knots (combination knots). This study investigates the strength of a combination knot, compared with other techniques.

Methods

In this observational cohort study, we assessed the strengths of square, slip-granny, slip-reef, and combination knots using absorbable monofilament sutures, and compared them using ANOVA and a multilevel linear regression analysis. We also assessed the correlation between the number of throws and knot strength using Spearman’s correlation analysis.

Results

Among 80 ligatures, ANOVA indicated significant differences in knot strength among the techniques (p < 0.01). Multilevel linear regression showed that a combination knot was stronger than a slip knot (p < 0.01) and comparable to a square knot (p = 0.0721). Secondary analysis indicated that for combination knots, five throws could achieve sufficient knot strength.

Conclusion

Combination knots are as strong as square knots and stronger than slip knots, and thus present a reasonable option for surgical ligation.
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Metadata
Title
Comparative strength of ligature points achieved by various surgical knot-tying techniques: an observational study using Maxon™ monofilament sutures
Authors
Shoichi Tsuzaka
Yuji Konishi
Kazuhiro Mino
Naotake Honma
Hideki Kawamura
Takuto Yoshida
Akinobu Taketomi
Publication date
28-09-2024
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02936-5
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