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Am J Obstet Gynecol. 2004 Nov;191(5):1618-20.

The effect of number of throws on knot security with nonidentical sliding knots.

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  • 1Division of Gynecologic Pelvic Surgery, Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, Shreveport, LA, USA.



The study was undertaken to test the integrity of nonidentical sliding knots made with 3 throws compared with those made with 6 throws with monofilament and braided absorbable suture.


The 3 throw nonidentical sliding knot was compared with the 6 throw nonidentical sliding knot in 4 different suture groups. The groups were 0-0 polydioxanone, 2-0 polydioxanone, 0-0 polyglactin 910, and 2-0 polyglactin 910. Knots were tested to failure with a tensiometer. The proportion of 3 throw knots becoming untied was compared with the 6 throw knot within each group. Ultimate load required to break tied knots within each suture group was also evaluated.


The 3 throw knots had very high rates of knot failure and untied significantly more often than the 6 throw knots.


The 6 throw nonidentical sliding knot demonstrates superior knot integrity compared with the 3 throw knot with both monofilament and braided absorbable suture.

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