In vitro evaluation of the modified forwarder knot used to end a continuous suture pattern in large-gauge suture

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dc.contributor.author Gillen, Alex
dc.contributor.author Auck, Stephanie
dc.contributor.author Munsterman, Amelia
dc.contributor.author Barrett, Erin
dc.contributor.author Caston, Stephanie
dc.contributor.author Kersh, Kevin
dc.contributor.author Tatarniuk, Dane
dc.contributor.author Swor, Tamara
dc.contributor.author Hanson, R. Reid
dc.contributor.department Veterinary Clinical Sciences
dc.date 2020-09-28T17:32:18.000
dc.date.accessioned 2021-02-26T13:37:58Z
dc.date.available 2021-02-26T13:37:58Z
dc.date.copyright Wed Jan 01 00:00:00 UTC 2020
dc.date.issued 2020-09-22
dc.description.abstract <p><strong>Objective</strong> To evaluate the strength and size of forwarder end (FE) knots modified to end continuous suture lines compared with Aberdeen (AB), square (SQ), and surgeon's (SU) knots.</p> <p><strong>Study design</strong> In vitro mechanical study.</p> <p><strong>Study population</strong> Knotted suture.</p> <p><strong>Methods</strong> Knots were tied with 2 USP (United States Pharmacopeia) polydioxanone, 2 USP, and 3 USP polyglactin 910 and tested on a universal testing machine under linear tension. Mode of failure and knot holding capacity (KHC) were recorded, and relative knot security (RKS) was calculated. Knot volume and weight were determined by digital micrometer and balance. Knot holding capacity, RKS, size, and weight between knot type, number of throws, and suture type and size were compared by using analysis of variance testing, with P < .05 considered significant.</p> <p><strong>Results</strong> In all suture types and number of throws, FE knot KHC/RKS was 28% to 66.99% (1.2‐1.6 fold) stronger compared with SQ/SU knots (P < .001). For 2 USP polydioxanone, FE knots had 10% (1.1 fold) higher KHC/RKS compared with AB knots (P < .042). However, in 2 and 3 USP polyglactin 910, FE knot KHC/RKS values were not different from those of AB knots (P > .080). Forwarder end/AB knots failed by suture breakage at the knot, whereas some SQ/SU knots unraveled. Forwarder end knots in 2 and 3 USP polyglactin 910 were 21.1% to 44.4% (1.2‐1.4 fold) smaller compared with SQ/SU knots (P < .028). Forwarder end knots in 2 and 3 USP polyglactin 910 were 40% to 99% (1.4‐2.0 fold) larger compared with AB knots (P < .001).</p> <p><strong>Conclusion</strong> Forwarder end knots provided increased KHC/RKS compared with SQ/SU knots.</p> <p><strong>Clinical relevance</strong> Forwarder end knots should be considered for closures when suture is placed under tension.</p>
dc.description.comments <p>This article is published as Gillen, Alex, Amelia Munsterman, Erin Barrett, Stephanie Caston, Kevin Kersh, Dane Tatarniuk, Tamara Swor, and R. Reid Hanson. "In vitro evaluation of the modified forwarder knot used to end a continuous suture pattern in large-gauge suture." <em>Veterinary Surgery </em>(2020). DOI: <a href="https://doi.org/10.1111/vsu.13519" target="_blank">10.1111/vsu.13519</a>. Posted with permission.</p>
dc.format.mimetype application/pdf
dc.identifier archive/lib.dr.iastate.edu/vcs_pubs/48/
dc.identifier.articleid 1047
dc.identifier.contextkey 19569582
dc.identifier.s3bucket isulib-bepress-aws-west
dc.identifier.submissionpath vcs_pubs/48
dc.identifier.uri https://dr.lib.iastate.edu/handle/20.500.12876/98903
dc.language.iso en
dc.source.bitstream archive/lib.dr.iastate.edu/vcs_pubs/48/2020_CastonStephanie_InVitroEvaluation.pdf|||Sat Jan 15 00:27:33 UTC 2022
dc.source.uri 10.1111/vsu.13519
dc.subject.disciplines Surgery
dc.subject.disciplines Veterinary Medicine
dc.title In vitro evaluation of the modified forwarder knot used to end a continuous suture pattern in large-gauge suture
dc.type article
dc.type.genre article
dspace.entity.type Publication
relation.isAuthorOfPublication 1c1bb4d0-92d3-4b12-9818-8ad2c44ee517
relation.isOrgUnitOfPublication 1ad68def-86ae-460b-8808-f1b1febafd0a
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