Reinforcing Effect of a Cyanoacrylate Adhesive on Surgical Suture Knots

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Title: Reinforcing Effect of a Cyanoacrylate Adhesive on Surgical Suture Knots
Author: Samson, Genevieve
Advisors: Tushar K. Ghosh, Committee Member
Hechmi Hamouda, Committee Member
Martin W. King, Committee Co-Chair
Bhupender S. Gupta, Committee Co-Chair
Abstract: Despite the latest polymer materials and surgical suturing techniques, the knot will always be the weakest point of the tied suture loop. In theory, the knot must be as small as possible to prevent an excessive amount of tissue reaction and a delay in healing. There have been reports suggesting that topical cyanoacrylate adhesives could have a reinforcing effect on a surgeon’s knot. Such an outcome could lead to the elimination of knot slippage and the unsatisfactory performance of some surgical knots. The main purpose of this study was to determine if cyanoacrylate adhesive could have a significant reinforcing effect on typical suture types and sizes when tied as a surgeon’s knot. The second aim was to evaluate if the cyanoacrylate adhesive could replace an additional throw in the surgeon’s knot so as to achieve an equivalent mechanical performance. The topical cyanoacrylate adhesive LiquiBand® was combined with six different suture materials (TicronTM, SurgidacTM, Ethilon*, Nurolon*, BiosynTM and PDS*II) in four different sizes (USP 5-0, USP 3-0, USP 0 and USP 1). The surgeon’s knot (2=1) with and without one (2=1=1) and two additional throws (2=1=1=1) were tied in a reproducible way and mechanically tested. Six dependent variables were used to evaluate the performance of each knot with and without adhesive. The performance criteria were: the force at loop failure, the maximum loop-holding force, the loop holding capacity, the knot efficiency, the knot elongation efficiency and the loop distraction. From the results and from scanning electron microscopic observations of the reinforced knots, the cyanoacrylate adhesive was found to significantly improve the knot performance. The improvement was superior with braided sutures and with absorbable polymer sutures. The reinforcement was more significant with thicker suture sizes and with the plain surgeon’s knot. Finally, it was found that, according to the six performance criteria, the cyanoacrylate adhesive could not replace an additional throw in the surgeon’s knot.
Date: 2009-04-16
Degree: MS
Discipline: Textile Engineering

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