The Effect of Instrumentation on Suture Tensile Strength and Knot Pullout Strength of Common Suture Materials

OBJECTIVE: To determine the effect of instrumentation of suture material on knot security and tensile strength. STUDY DESIGN: In all, 5 types of suture material were used; 10 knots were tied without any instrumentation and 10 knots were tied with a hemostat holding tension on the first throw while the second throw was made for each suture type. Each group was tested to failure with the maximum load and mode of failure recorded. The maximum load between groups of each suture type was compared; frequency of failure through knot slippage vs material fracture was also compared between groups. RESULTS: There was no significant difference observed in the maximum load to failure for any suture type between instrumented and noninstrumented groups. Additionally, there was no difference between any instrumented and noninstrumented groups for material failure vs failure due to knot slippage. CONCLUSIONS: Instrumentation of suture material during two-hand tying does not affect the strength of suture material or knot security. (Published by Elsevier Inc on behalf of the Association of Program Directors in Surgery)