Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures
Purpose Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is c...
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Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2012-12, Vol.20 (12), p.2602-2605 |
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creator | Türker, Mehmet Yalçinozan, Mehmet Çirpar, Meriç Çetik, Özgür Kalayciolu, Baris |
description | Purpose
Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation.
Methods
Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop.
Results
Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw.
Conclusion
Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation. |
doi_str_mv | 10.1007/s00167-012-1882-0 |
format | Article |
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Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation.
Methods
Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop.
Results
Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw.
Conclusion
Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-012-1882-0</identifier><identifier>PMID: 22261991</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Approximation ; Evaluation ; Experimental Study ; Failure ; Humans ; Knees ; Load ; Medicine ; Medicine & Public Health ; Orthopedics ; Polypropylenes ; Practice ; Rehabilitation ; Sports ; Stress ; Surgery ; Surgical Instruments ; Suture Techniques - adverse effects ; Suture Techniques - instrumentation ; Sutures ; Tensile Strength ; Testing laboratories ; Treatment Failure ; Work load</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2012-12, Vol.20 (12), p.2602-2605</ispartof><rights>Springer-Verlag 2012</rights><rights>Springer-Verlag Berlin Heidelberg 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-deed511d1aff4134283fcb522ec674a216b8ec43eded76a7995031ed27fd750c3</citedby><cites>FETCH-LOGICAL-c405t-deed511d1aff4134283fcb522ec674a216b8ec43eded76a7995031ed27fd750c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-012-1882-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-012-1882-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22261991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Türker, Mehmet</creatorcontrib><creatorcontrib>Yalçinozan, Mehmet</creatorcontrib><creatorcontrib>Çirpar, Meriç</creatorcontrib><creatorcontrib>Çetik, Özgür</creatorcontrib><creatorcontrib>Kalayciolu, Baris</creatorcontrib><title>Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation.
Methods
Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop.
Results
Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw.
Conclusion
Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.</description><subject>Approximation</subject><subject>Evaluation</subject><subject>Experimental Study</subject><subject>Failure</subject><subject>Humans</subject><subject>Knees</subject><subject>Load</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Polypropylenes</subject><subject>Practice</subject><subject>Rehabilitation</subject><subject>Sports</subject><subject>Stress</subject><subject>Surgery</subject><subject>Surgical Instruments</subject><subject>Suture Techniques - adverse effects</subject><subject>Suture Techniques - instrumentation</subject><subject>Sutures</subject><subject>Tensile Strength</subject><subject>Testing laboratories</subject><subject>Treatment Failure</subject><subject>Work load</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc2KFDEUhYMoTjv6AG4k4MZN6b1JpVK1lGb8gQE3ug7pyk1PjdVJmaTEfnvTdCsiCGaTQL5z8vMx9hzhNQLoNxkAO90Aigb7XjTwgG2wlbLRstUP2QaGVjQCVHfFnuR8D1CX7fCYXQkhOhwG3LC77WwPC_fTD1umGHiJfEn0nULha_BxdlPY8-i55XktayL-NcTCHY2JbKbMC4U8zcRzSRT25e7ELnE-Likux5kCXXL5KXvk7Zzp2WW-Zl_e3XzefmhuP73_uH1724wtqNI4IqcQHVrvW5St6KUfd0oIGjvdWoHdrqexleTI6c7qYVAgkZzQ3mkFo7xmr8699QbfVsrFHKY80jzbQHHNBoXSWkOv9H-gAmSn6qjoy7_Q-7imUB9iEAcNXf1qqBSeqTHFnBN5s6TpYNPRIJiTMXM2ZqoxczJmTpkXl-Z1dyD3O_FLUQXEGch1K-wp_XH0P1t_AitgodA</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Türker, Mehmet</creator><creator>Yalçinozan, Mehmet</creator><creator>Çirpar, Meriç</creator><creator>Çetik, Özgür</creator><creator>Kalayciolu, Baris</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20121201</creationdate><title>Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures</title><author>Türker, Mehmet ; Yalçinozan, Mehmet ; Çirpar, Meriç ; Çetik, Özgür ; Kalayciolu, Baris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-deed511d1aff4134283fcb522ec674a216b8ec43eded76a7995031ed27fd750c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Approximation</topic><topic>Evaluation</topic><topic>Experimental Study</topic><topic>Failure</topic><topic>Humans</topic><topic>Knees</topic><topic>Load</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Polypropylenes</topic><topic>Practice</topic><topic>Rehabilitation</topic><topic>Sports</topic><topic>Stress</topic><topic>Surgery</topic><topic>Surgical Instruments</topic><topic>Suture Techniques - adverse effects</topic><topic>Suture Techniques - instrumentation</topic><topic>Sutures</topic><topic>Tensile Strength</topic><topic>Testing laboratories</topic><topic>Treatment Failure</topic><topic>Work load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Türker, Mehmet</creatorcontrib><creatorcontrib>Yalçinozan, Mehmet</creatorcontrib><creatorcontrib>Çirpar, Meriç</creatorcontrib><creatorcontrib>Çetik, Özgür</creatorcontrib><creatorcontrib>Kalayciolu, Baris</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Türker, Mehmet</au><au>Yalçinozan, Mehmet</au><au>Çirpar, Meriç</au><au>Çetik, Özgür</au><au>Kalayciolu, Baris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>20</volume><issue>12</issue><spage>2602</spage><epage>2605</epage><pages>2602-2605</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation.
Methods
Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop.
Results
Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw.
Conclusion
Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22261991</pmid><doi>10.1007/s00167-012-1882-0</doi><tpages>4</tpages></addata></record> |
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language | eng |
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source | MEDLINE; SpringerNature Journals; Access via Wiley Online Library |
subjects | Approximation Evaluation Experimental Study Failure Humans Knees Load Medicine Medicine & Public Health Orthopedics Polypropylenes Practice Rehabilitation Sports Stress Surgery Surgical Instruments Suture Techniques - adverse effects Suture Techniques - instrumentation Sutures Tensile Strength Testing laboratories Treatment Failure Work load |
title | Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures |
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