Knot integrity with nonidentical and parallel sliding knots

Am J Obstet Gynecol. 2004 Jan;190(1):83-6. doi: 10.1016/s0002-9378(03)00947-5.


Objective: The study was performed to test the knot integrity of parallel and nonidentical sliding knots with the use of monofilament suture.

Study design: We investigated the proportion of parallel sliding knots that become untied compared with nonidentical sliding knots in four different monofilament suture configurations: group A, 6 throws, 0-0 gauge; group B, 10 throws, 0-0 gauge; group C, 6 throws, 2-0 gauge; group D, 10 throws, 2-0 gauge. Each combination was tested 20 times, for a total of 160 knots.

Results: The nonidentical sliding knot untied 40% of the time in group A compared with 0% for the parallel knot (P=.003). In the other 6-throw group, group C, 45% of the nonidentical knots became untied compared with 0% of the parallel knots (P=.001). There were no significant differences in the proportions of untying for each knot type in the 10-throw groups.

Conclusion: Parallel sliding knots demonstrate superior knot integrity compared with nonidentical sliding knots with monofilament suture. The addition of throws to the nonidentical knot improves its knot security.

Publication types

  • Comparative Study

MeSH terms

  • Humans
  • Suture Techniques*
  • Tensile Strength