Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
15 Jul 2018

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Editorial Type:
Special Report

Evaluation of various hemostatic knot configurations performed by veterinary students

Gessica Giusto DVM1, Francesco Comino DVM2, Cristina Vercelli DVM, PhD3, Vittorio Caramello DVM4, Emanuela Morello DVM, PhD5, and Marco Gandini DVM, PhD6
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  • 1 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
  • | 2 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
  • | 3 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
  • | 4 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
  • | 5 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
  • | 6 Department of Veterinary Sciences, University of Turin, 10095 Grugliasco TO, Italy.
DOI:
https://doi.org/10.2460/javma.253.2.219
Volume/Issue:
Volume 253: Issue 2
Online Publication Date:
15 Jul 2018
Restricted access
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Abstract

OBJECTIVE To determine the most effective hemostatic knot configuration performed by veterinary students following a brief training session with an experienced surgeon and a subsequent deliberate self-training period.

DESIGN Experiment.

SAMPLE 24 fourth-year veterinary students with no previous surgical knot–tying experience.

PROCEDURES In a 1-hour training session, an experienced surgeon showed veterinary students how to perform 5 hemostatic knot configurations (giant, slip, strangle, surgeon's, and transfixing), which they then practiced at home on a hemostasis simulator for 2 weeks. Thereafter, students performed each knot 4 times (twice each with monofilament and multifilament suture) on a hemostasis simulator. An experienced surgeon evaluated the correct execution of knots and measured their effectiveness by use of a manometer to measure vessel pressure distal to the ligature. Each student completed a questionnaire regarding their perceived learning and execution difficulty and sealing security for each knot. Responses were compared among knots and suture materials.

RESULTS Overall, students considered the surgeon's knot the easiest to learn and the strangle knot the most difficult. The slipknot was also considered the easiest knot to perform, and the giant knot was considered the most difficult. The strangle knot was deemed the most effective in reducing vessel pressure distal to the ligature.

CONCLUSIONS AND CLINICAL RELEVANCE The strangle knot was the most effective hemostatic knot in inexperienced hands, although veterinary students considered it more difficult to learn than other, perhaps more commonly taught, knots. Therefore, teaching of the strangle knot should be encouraged in veterinary schools.

Supplementary Materials

    • Supplementary Appendix S1 (PDF 52 kb)

Contributor Notes

Address correspondence to Dr. Gandini (marco.gandini@unito.it).