Editorial Type:
Surgery

In vitro evaluation of the knot-holding capacity and security, weight, and volume of forwarder knots tied with size-3 polyglactin 910 suture exposed to air, balanced electrolyte solution, or equine abdominal fat

Leah McGlinchey 1Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849.

Search for other papers by Leah McGlinchey in
Current site
Google Scholar
PubMed Close
 MVB, MS
,
Lindsey H. Boone 1Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849.

Search for other papers by Lindsey H. Boone in
Current site
Google Scholar
PubMed Close
 DVM, PhD
,
Amelia S. Munsterman 3Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

Search for other papers by Amelia S. Munsterman in
Current site
Google Scholar
PubMed Close
 DVM, MS, PhD
,
Matthew O. D. Coleridge 4Fethard Equine Hospital, R689, Fethard, Ireland.

Search for other papers by Matthew O. D. Coleridge in
Current site
Google Scholar
PubMed Close
 BVMS, MS
,
Sarah M. Rosanowski 5Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR.

Search for other papers by Sarah M. Rosanowski in
Current site
Google Scholar
PubMed Close
 PhD
,
Ramsis Farag 2Center of Polymers and Advanced Composites, Samuel Ginn College of Engineering, Auburn University, Auburn, AL 36849.
6Department of Textile Engineering, Manosoura University, Dakahlia Governorate 35516, Egypt.

Search for other papers by Ramsis Farag in
Current site
Google Scholar
PubMed Close
 PhD
, and
R. Reid Hanson 1Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849.

Search for other papers by R. Reid Hanson in
Current site
Google Scholar
PubMed Close
 DVM
DOI:
https://doi.org/10.2460/ajvr.80.7.709
Volume/Issue:
Volume 80: Issue 7
Online Publication Date:
01 Jul 2019
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To evaluate the effect of exposure to a balanced electrolyte solution (BES), or equine abdominal fat on the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of forwarder knots versus surgeon's knots.

SAMPLE

315 knots tied and tested in vitro.

PROCEDURES

United States Pharmacopeia size-3 polyglactin 910 suture exposed to air (dry [control]), equine abdominal fat (fat-exposed), or BES (BES-exposed) was used to tie forwarder knots with 2, 3, and 4 throws and surgeon's knots with 5, 6, 7, and 8 throws. A universal materials testing machine was used to test the tensile strength of suture and knots to failure, and the KHC, RKS, weight, and volume of knots were determined.

RESULTS

Forwarder knots had significantly higher KHC and RKS and lower volume, compared with surgeons’ knots. Forwarder knots tied with fat-exposed suture had greater weight, but not volume, than did forwarder knots tied with dry or BES-exposed suture with the same number of throws.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that forwarder knots were superior to surgeon's knots when configured as start knots intended for continuous lines of suture. Exposure to media did not negatively affect mechanical or physical properties of forwarder knots and may improve specific biomechanical functions, including KHC and RKS.

Abstract

OBJECTIVE

To evaluate the effect of exposure to a balanced electrolyte solution (BES), or equine abdominal fat on the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of forwarder knots versus surgeon's knots.

SAMPLE

315 knots tied and tested in vitro.

PROCEDURES

United States Pharmacopeia size-3 polyglactin 910 suture exposed to air (dry [control]), equine abdominal fat (fat-exposed), or BES (BES-exposed) was used to tie forwarder knots with 2, 3, and 4 throws and surgeon's knots with 5, 6, 7, and 8 throws. A universal materials testing machine was used to test the tensile strength of suture and knots to failure, and the KHC, RKS, weight, and volume of knots were determined.

RESULTS

Forwarder knots had significantly higher KHC and RKS and lower volume, compared with surgeons’ knots. Forwarder knots tied with fat-exposed suture had greater weight, but not volume, than did forwarder knots tied with dry or BES-exposed suture with the same number of throws.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that forwarder knots were superior to surgeon's knots when configured as start knots intended for continuous lines of suture. Exposure to media did not negatively affect mechanical or physical properties of forwarder knots and may improve specific biomechanical functions, including KHC and RKS.

Supplementary Materials

    • Supplementary Video s1 (MP4 15.15 MB)

Contributor Notes

Dr. McGlinchey's present address is Scone Equine Hospital, 106 Liverpool St, Scone, NSW 2337, Australia.

Address correspondence to Dr. Hanson (hansorr@auburn.edu).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Jul 2019

  • 1. KĂĽmmerle JM. Suture materials and patterns. In: Auer JA, Stick JA, eds. Equine surgery. 4th ed. St Louis: Elsevier-Saunders, 2012;181–202.

    • Search Google Scholar
    • Export Citation

  • 2. Gillen AM, Munsterman AS, Hanson RR. In vitro evaluation of the size, knot holding capacity, and knot security of the forwarder knot compared to square and surgeon's knots using large gauge suture. Vet Surg 2016;45:1034–1040.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 3. Coleridge M, Gillen AM, Farag R, et al. Effect of fluid media on the mechanical properties of continuous pattern-ending surgeon's, square, and Aberdeen knots in vitro. Vet Surg 2017;46:306–315.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 4. Gillen AM, Munsterman AS, Farag R, et al. In vitro evaluation of the Aberdeen knot for continuous suture patterns with large gauge suture. Vet Surg 2016;45:955–961.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 5. Israelsson LA, Jonsson T. Physical properties of self locking and conventional surgical knots. Eur J Surg 1994;160:323–327.

  • 6. Schaaf O, Glyde M, Day RE. In vitro comparison of secure Aberdeen and square knots with plasma- and fat-coated polydioxanone. Vet Surg 2010;39:553–560.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 7. Gupta BS, Wolf KW, Postlethwait RW. Effect of lubrication of frictional properties of sutures. Surg Gynecol Obstet 1985;161:416–418.

    • Search Google Scholar
    • Export Citation

  • 8. Schaaf O, Glyde M, Day RE. A secure Aberdeen knot: in vitro assessment of knot security in plasma and fat. J Small Anim Pract 2009;50:415–421.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. Sanders RE, Kearney CM, Buckley CT, et al. Knot security of 5 metric (USP 2) sutures: influence of knotting technique, suture material, and incubation time for 14 and 28 days in phosphate buffered saline and inflamed equine peritoneal fluid. Vet Surg 2015;44:723–730.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 10. McGlinchey L, Hanson RR, Boone LH, et al. Bursting strength of surgeon's and self-locking knots for closure of ventral midline celiotomy in horses. Vet Surg 2018;47:1080–1086.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 11. Gillen AM, Munsterman AS, Farag R, et al. In vitro evaluation of square and surgeon's knots in large gauge suture. Vet Surg 2017;46:297–305.

  • 12. Herrmann JB. Tensile strength and knot security of surgical suture materials. Am Surg 1971;37:209–217.

  • 13. Bourne RB, Bitar H, Andreae PR, et al. In-vivo comparison of four absorbable sutures: Vicryl, Dexon Plus, Maxon and PDS. Can J Surg 1988;31:43–45.

    • Search Google Scholar
    • Export Citation

  • 14. Muffly TM, Boyce J, Kieweg SL, et al. Tensile strength of a surgeon's or a square knot. J Surg Educ 2010;67:222–226.

  • 15. Tera H, Aberg C. Strength of knots in surgery in relation to type of knot, type of suture material and dimension of suture thread. Acta Chir Scand 1977;143:75–83.

    • Search Google Scholar
    • Export Citation

  • 16. van Rijssel EJ, Brand R, Admiraal C, et al. Tissue reaction and surgical knots: the effect of suture size, knot configuration, and knot volume. Obstet Gynecol 1989;74:64–68.

    • Search Google Scholar
    • Export Citation

  • 17. Trostle SS, Hendrickson DA. Suture sinus formation following closure of ventral midline incisions with polypropylene in three horses. J Am Vet Med Assoc 1995;207:742–745.

    • Search Google Scholar
    • Export Citation

  • 18. Mair TS, Smith LJ, Sherlock CE. Evidence-based gastrointestinal surgery in horses. Vet Clin North Am Equine Pract 2007;23:267–292.

  • 19. Freeman DE, Rötting AK, Inoue OJ. Abdominal closure and complications. Clin Tech Equine Pract 2002;1:174–187.

  • 20. Edlich RF, Panek PH, Rodeheaver GT, et al. Physical and chemical configuration of sutures in the development of surgical infection. Ann Surg 1973;177:679–688.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 21. Ducharme NG, Hackett RP, Durcharme GR, et al. Surgical treatment of colic: results in 181 horses. Vet Surg 1983;12:206–209.

Advertisement