Effect of fluid media on the mechanical properties of continuous pattern-ending surgeon's, square, and Aberdeen knots in vitro.
Authors: Coleridge Matthew, Gillen Alexandra M, Farag Ramsis, Hanson R Reid, Munsterman Amelia S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Surgeons closing equine abdominal wounds with continuous suture patterns must choose knots that will reliably hold under the challenging wet, contaminated environment of the peritoneal cavity. Coleridge and colleagues tested three common knot configurations (surgeon's, square, and Aberdeen) tied in various throw combinations using large-gauge polydioxanone and polyglactin 910 sutures, exposing them to fluids mimicking surgical conditions—balanced electrolyte solution, sodium carboxymethylcellulose, equine serum, and equine fat—before loading each knotted strand to failure on a materials testing machine. Contrary to what might be expected, exposure to surgical media either preserved or significantly improved knot-holding capacity across all configurations, with Aberdeen knots consistently outperforming the other two types; notably, surgeon's and square knots with polyglactin 910 showed substantial strength gains (5–6 throws) when exposed to media compared with dry knots, whilst Aberdeen knots improved under both suture types. The practical recommendation is to terminate continuous patterns with Aberdeen knots using three throws and one turn in polyglactin 910, which delivered superior holding strength whilst requiring the least suture material—a finding that directly translates to reduced tissue trauma and foreign body burden in equine surgical closures.
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Practical Takeaways
- •Use Aberdeen knots for continuous abdominal closure patterns in equine surgery—they hold as well or better than traditional knots while using less suture material, reducing tissue reaction
- •Don't worry about surgical site fluid exposure affecting knot security; wet conditions either maintain or improve knot holding capacity for all knot types tested
- •For equine abdominal surgery, tie Aberdeen knots with 3 polyglactin 910 using only 3 throws and 1 turn—this provides reliable security with minimal suture burden
Key Findings
- •Aberdeen knots demonstrated superior knot holding capacity (KHC) while requiring less suture material than surgeon's or square knots
- •Media exposure (balanced electrolyte solution, sodium carboxymethylcellulose, equine serum, or equine fat) either had no effect or significantly improved KHC across all knot types tested
- •Surgeon's and square knots with media-exposed 3 polyglactin 910 showed significantly higher KHC at 5-6 throws compared to dry controls
- •Aberdeen knots with 3 polyglactin 910 and 3 throws with 1 turn demonstrated optimal performance in terms of knot holding capacity and suture efficiency