Dhillon, Mehar; Pastor, Tatjana; Zderic, Ivan; Hebsacker, Sarina; Link, Björn-Christian; Fletcher, James; Richards, R Geoff; Gueorguiev, Boyko; Pastor, Torsten (2024). Biomechanical evaluation of double-stranded knot configurations in high-strength sutures and tapes. (In Press). European journal of trauma and emergency surgery Springer 10.1007/s00068-024-02566-z
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PURPOSE
Recently, a new dynamic high-strength suture (DC) was introduced, also available in tape form (DT), featuring a salt-infused silicone core attracting water in a fluid environment to preserve tissue approximation. The aims of this study were to (1) assess the influence of securing throw number on knot security of two double-stranded knot configurations (Cow-hitch and Nice-knot) tied with either dynamic (DC and DT) or conventional (FW and ST) high-strength sutures and tapes, and (2) compare the ultimate force and knot slippage of the novel dynamic versus conventional sutures and tapes when used with their minimal number of needed securing throws.
METHODS
Seven specimens of each FW, ST, DC and DT were considered for tying with Cow-hitch or Nice-knots. The base of these Cow-hitch and Nice-knots was secured with surgeons` knots using 1-3 alternating throws. Tensile tests were conducted under physiologic conditions to evaluate knot slippage, ultimate force at rupture, and minimum number of throws ensuring 100% knot security. RESULTS: For both Cow-hitch and Nice-knots, 100% security was achieved with 2 securing throws for DC, DT, ST, and with 3 securing throws for FW. With these minimum numbers of securing throws, ultimate force was significantly higher for Nice-knots versus Cow-hitch tied with DT (p = 0.001) and slippage was significantly less with Nice-knots versus Cow-hitch tied with DC (p = 0.019).
CONCLUSIONS
The minimum number of securing throws required to achieve 100% security was 2 with DC, DT and ST for both Cow-hitch and Nice-knots configurations, in contrast to FW where 3 securing throws were needed. With these minimum numbers of securing throws, Nice-knots were associated with significantly higher ultimate forces when using DT and lower slippage with DC versus Cow-hitch knots.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery |
UniBE Contributor: |
Pastor, Tatjana |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1863-9941 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Jun 2024 12:07 |
Last Modified: |
25 Jun 2024 12:15 |
Publisher DOI: |
10.1007/s00068-024-02566-z |
PubMed ID: |
38907860 |
Additional Information: |
Mehar Dhillon and Tatjana Pastor contributed equally to this work. |
Uncontrolled Keywords: |
Cow-hitch DynaTape FibreWire SutureTape Double-stranded DynaCord Nice-knot |
BORIS DOI: |
10.48350/198044 |
URI: |
https://boris.unibe.ch/id/eprint/198044 |
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