A New Twist on the Surgeon's Knot: Quantifying Suture Security.

IF 2.5 3区 医学 Q2 DERMATOLOGY Dermatologic Surgery Pub Date : 2024-11-06 DOI:10.1097/DSS.0000000000004493
Omeed Modiri, Joseph Ebriani, Andrew Sauvageau, Jeremy Davis
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Abstract

Background: The reliability and security of surgical knots play a critical role in wound closure and healing. A surgeon's knot, created by a modification of the square knot in which an extra 'twist' is added to the initial throw, is often used to increase friction and provide stability of the tissue as the knot is completed.

Objective: The purpose of this study was to quantify the security of sutures, as influenced by varying numbers of initial twists in a surgeon's knot.

Materials and methods: Using pig's feet for simulation, the study compared the security of knots tied with 2 types of sutures in 3 different sizes, examining the impact of 1 to 6 initial twists. Univariable linear regression was performed to evaluate the association between increased twists and the force required to loosen each knot.

Results: These data showed that suture security generally improves with an increasing number of twists, up to 5, beyond which benefits diminish in certain suture sizes.

Conclusion: Increasing the number of twists in a surgeon's knot significantly enhances suture integrity, with optimal results in knot security observed between 3 to 5 twists, suggesting that a balance is necessary between knot security and ease of application.

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外科医生之结的新变化:量化缝合安全性。
背景:手术结的可靠性和安全性对伤口闭合和愈合起着至关重要的作用。外科医生绳结是方形绳结的一种改良,在最初抛出时增加了一个 "捻度",通常用于增加摩擦力,并在完成绳结时提供组织的稳定性:本研究的目的是量化外科医生打结时不同数量的初始捻线对缝合安全性的影响:该研究使用猪蹄进行模拟,比较了 3 种不同大小的 2 种缝线打结的安全性,研究了 1 到 6 个初始捻度的影响。研究还进行了单变量线性回归,以评估扭结增加与松开每个结所需力量之间的关系:结果:这些数据表明,随着捻线次数的增加,缝合安全性普遍提高,最多可增加到 5 次,超过 5 次后,某些缝合线尺寸的缝合安全性就会降低:结论:增加外科医生缝合线结的捻度可显著提高缝合的完整性,3 到 5 个捻度之间的缝合线结安全性最佳,这表明在缝合线结的安全性和应用的简便性之间需要取得平衡。
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来源期刊
Dermatologic Surgery
Dermatologic Surgery 医学-皮肤病学
CiteScore
3.10
自引率
16.70%
发文量
547
期刊介绍: Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.
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