Handling characteristics of braided suture materials for tight tying (original) (raw)
Related papers
Polymers, 2016
The aim of this study was to evaluate and compare the mechanical properties of five suture materials on three knot configurations when subjected to different physical conditions. Five 5-0 (silk, polyamide 6/66, polyglycolic acid, glycolide-e-caprolactone copolymer, polytetrafluoroethylene) suture materials were used. Ten samples per group of each material were used. Three knot configurations were compared A.2=1=1 (forward-forward-reverse), B.2=1=1 (forward-reverse-forward), C.1=2=1 (forward-forward-reverse). Mechanical properties (failure load, elongation, knot slippage/breakage) were measured using a universal testing machine. Samples were immersed in three different pH concentrations (4,7,9) at room temperature for 7 and 14 days. For the thermal cycle process, sutures were immersed in two water tanks at different temperatures (5 and 55˝C). Elongation and failure load were directly dependent on the suture material. Polyglycolic acid followed by glycolide-e-caprolactone copolymer showed the most knot failure load, while polytetrafluoroethylene showed the lowest (p < 0.001). Physical conditions had no effect on knot failure load (p = 0.494). Statistically significant differences were observed between knot configurations (p = 0.008). Additionally, individual assessment of suture material showed statistically significant results for combinations of particular knot configurations. Physical conditions, such as pH concentration and thermal cycle process, have no influence on suture mechanical properties. However, knot failure load depends on the suture material and knot configuration used. Consequently, specific suturing protocols might be recommended to obtain higher results of knot security.
Effect of Fibre and Yarn Structural Parameters on the Mechanical Properties of Silk Suture Yarns
As sutures are devices to close wounds after an injury or surgery, they must not only possess enough strength to hold tissues securely but also must be flexible enough to be knotted. Thus, the tensile and bending properties are of paramount importance for the success of the suture yarns. In this paper, these properties were measured for silk suture yarns of varying diameter in order to evaluate the influence of fibre and yarn structural parameters on the mechanical performance and knot efficiency. It was observed that coarser suture yarns exhibited higher bending rigidity and greater reduction in knotted yarn strength than the finer yarns. Suture yarns with finer fibres would be ideal as suture material as they would be able to elongate under low loads to accommodate any developing wound edema. In could be deduced from the study that for a particular application, the surgeon must use the smallest diameter suture that will hold the wound tissue in view of better flexibility and knot ...
Veterinary Surgery, 2010
Objective-To evaluate the effect of 6 different knotting methods on the mechanical properties of 3 large absorbable suture materials used in large animal surgery. Study Design-In vitro mechanical study. Sample Population-Knotted suture loops (n=15 per group). Methods-Suture loops were created between two low-friction pulleys with either 2 polydioxanone, 2 polyglactin 910 or 3 polyglactin 910. Strands were tied using 1 of 6 knotting technique: square knot, surgeon knot, clamped surgeon's knot, sliding half-hitch knot (HH), Delimar knot and self-locking knot (SLK). A single cycle to failure test was performed on each suture loop with a distraction rate of 100 mm/min. Failure modes were evaluated and breaking strength, elongation to failure and stiffness were compared. Results-All loops except two HH failed at the knot by acute breaking. The double-stranded SLK was both stronger and stiffer than all other knots for each suture material. Clamping the first throw of the surgeon knot decreased load to failure significantly (143.11 AE 8.64 N) compared with not clamping (159.21 AE 6.14 N) for polydioxanone. Stiffness and elongation to failure were respectively lower and increased for 2 polydioxanone compared with both polyglactin 910 materials for all knotting techniques. Conclusions-Knotting techniques do influence structural properties of suture loops. The double strand loop conferred stiffer and stronger properties to the SLK Clinical Relevance-Clamping the first throw of polydioxanone should be avoided when tying a suture under tension even using large diameter suture materials. Using a SLK might be considered as a useful alternative when excessive tension is present.
Effect of Coefficient of Friction and Bending Rigidity on Handling Behaviour of Surgical Suture
Journal of The Institution of Engineers (India): Series E, 2019
The purpose of this study was to provide information on textile behaviour of suture materials in order to assist surgeons in their selection of adequate sutures for specific surgical applications. Commercially available absorbable and non-absorbable (both braided and monofilament) coated sutures of size 2-0 were used in this study. A comparative study between two different manufacturers, i.e. Johnson & Johnson (USA) and Sutures India (India), was also carried out during this work. On the basis of mechanical tests including suture-to-suture coefficient of friction, suture-to-skin coefficient of friction, bending rigidity, handling characteristic, i.e. knot tie-down roughness of suture materials were studied. Obtained results show that among these tests, suture-to-suture coefficient of friction and bending rigidity have significant effect on the handling characteristic of suture. Higher coefficient of friction exhibited by braided suture suggests that, despite of coating, asperities formed on these sutures resulted in their higher friction than monofilament ones.
Mechanical testing of different knot types using high-performance suture material
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Purpose This laboratory study aimed to evaluate the loop security, knot security, cyclic loading resistance and loadto-failure rate of three different knot types with establishing a new experimental setup. Additionally, the mode of failure of each knot was evaluated. Methods With the use of nonabsorbable, braided polyethylene sutures, USP size No. 2 [Hi-Fi Ò ; ConMed Linvatec], the arthroscopic knot types Dines, SMC as well as the surgeon's knot were tested using a material testing machine. The knots were tied openly as well as arthroscopically. The setup enables testing of knot configurations while eliminating friction between knot loop and its suspension points. Including all test procedures, a total of 216 knots were tested. Results All openly tied knot types and ten of each type of arthroscopically tied knots resisted against cyclic loading of 1,000 cycles. With subsequent load-to-failure testing, openly tied knot types achieved significantly higher values of tensile strength than arthroscopically tied knots. Regarding clinical failure, defined as an elongation of 3 mm, Dines knot reached highest loop as well as knot security. Knot slippage was the most common failure mechanism at an elongation of 3 mm, whereas suture breakage was evaluated most at an elongation of 6 mm. Conclusions The new experimental setup confirms the loop security of arthroscopic knot types. Using a knot pusher clinically is a key factor to attain this as compared to openly hand-tied techniques. The Dines knot presented the highest reliability. It may provide a secure tissue healing during rehabilitation and consequently can be recommended for clinical application.
Tensile mechanics of braided sutures
Textile Research Journal, 2012
Sutures are the materials primarily used for closing wounds, and their performance is significantly dependent on their mechanical characteristics. Thus, their tensile property is a key parameter responsible for the success of a suture. In this paper, a simple analytical tensile model of braided sutures has been developed based on braid geometry, braid kinematics, and constituent monofilament properties. The model has accounted for the changes in the braid geometry, including braid angle, diameter, and Poisson’s ratio. The kinematics of the braided suture is analyzed pertaining to monofilament locking or jamming in the braid. The model of jamming state of monofilaments has been presented, and both braid angle and diameter are found to be critical design parameters. The experimental results have been compared to the theoretical stress–strain curves of braided sutures, and an excellent agreement has been observed between them.
American Journal of Veterinary Research, 2020
OBJECTIVE To evaluate holding security of 4 friction knots created with various monofilament and multifilament sutures in a vascular ligation model. SAMPLE 280 friction knot constructs. PROCEDURES 10 friction knots of 4 types (surgeon's throw, Miller knot, Ashley modification of the Miller knot, and strangle knot) created with 2-0 monofilament (polyglyconate, polydioxanone, poliglecaprone-25, and glycomer-631) and braided multifilament (silk, lactomer, and polyglactin-910) sutures were separately tied on a mock pedicle and pressure tested to the point of leakage. Linear regression analysis was performed to compare leakage pressures among suture materials (within friction knot type) and among knot types (within suture material). RESULTS Mean leakage pressure of surgeon's throws was significantly lower than that of all other knots tested, regardless of the suture material used. All the other knots had mean leakage pressures considered supraphysiological. Significant difference...
Suture End Length as a Function of Knot Integrity
Journal of Surgical …, 2009
To evaluate tension at the failure of 3 commonly used sutures when suture ends were cut to 3 lengths. STUDY DESIGN: Knots were tied using U.S. Pharmacopeia Size 0 -0 polyglactin 910, silk, or polydioxanone sutures. The knots were tied randomly on a jig by the same surgeon. End lengths were then cut to random lengths of 0, 3, and 10 mm. We compared the individual knot strength when subjected to tensile forces via tensiometer with the point of knot failure, which was defined as untying and/or breaking of the knot.