Omeed Modiri, Joseph Ebriani, Andrew Sauvageau, Jeremy Davis
{"title":"A New Twist on the Surgeon's Knot: Quantifying Suture Security.","authors":"Omeed Modiri, Joseph Ebriani, Andrew Sauvageau, Jeremy Davis","doi":"10.1097/DSS.0000000000004493","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11289,"journal":{"name":"Dermatologic Surgery","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatologic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/DSS.0000000000004493","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
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.
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:
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Injectable neuromodulators-
Laser surgery-
Liposuction-
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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.