A novel and efficient surgical knotting technique for high-tension closures

Yongyun Chang; Degang Yu; Liao Wang; Jingwei Zhang; Mengning Yan; Huiwu Li; Yuanqing Mao; Zanjing Zhai

doi:10.21037/atm-20-6332

A novel and efficient surgical knotting technique for high-tension closures

Ann Transl Med. 2021 Mar;9(5):375. doi: 10.21037/atm-20-6332.

Authors

Yongyun Chang^{1

2}, Degang Yu¹, Liao Wang¹, Jingwei Zhang¹, Mengning Yan¹, Huiwu Li¹, Yuanqing Mao¹, Zanjing Zhai¹

Affiliations

¹ Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Background: The closure of high-tension incisions without any assistance can be difficult and challenging for surgeons. A common practice is to fix the first knot with a clamp and then tie a reverse locking knot; however, this practice has certain disadvantages. The aim of this study was to introduce a novel and efficient surgical knotting technique with various advantages.

Methods: The two knotting methods used in this study were the absorbable braided suture where the first suture was fixed with a clamp (with assistance) and the SH-9Hospital knotting technique (without assistance) applied on the smooth surface of a cylinder. Mechanical testing was performed using a universal material testing machine. The load-elongation curve and ultimate tensile load (UTL) were recorded.

Results: The mean knotting time was 36.40±1.50 s (range, 32-41 s) and 24.80±1.16 s (range, 21-28 s) in the clamp and SH-9Hosptial groups, respectively. The mean UTL was 120.8±10.14 N (range, 81.11-136.55 N)and 126.5±6.29 N (range, 104.88-139.56 N) in the clamp and SH-9Hospital groups, respectively. The knot strength of the SH-9Hospital technique was not inferior to traditional clinical practice.

Conclusions: The SH-9Hospital knotting technique was a secure, convenient, and efficient method for high-tension closure.

Keywords: Orthopaedic procedures; surgical clamps; suture technique; tensile strength; wound closure.