Despite widespread use of various suture materials, patterns, and knots, there are few comparisons of basic suture properties and performance. This in vitro mechanical study investigated 11 types of absorbable and nonabsorbable suture materials using 3 different knot patterns and 5 different knot sizes tied by 2 individuals of varied experience.
When testing tensile failure load, 1 of 2 braided sutures (lactomer [Polysorb, covidien.com]) was strongest; monofilament polyglytone 6211 (Caprosyn, covidien.com) was weakest. For polyglactin 910 (Vicryl, novartis.ethicon.com), nylon (Ethilon, novartis.ethicon.com; Monosof, covidien.com), polyglytone 6211, and polypropylene (Surgipro, covidien.com), knots made using 3 throws were statistically as secure as knots using up to 6 throws. For all remaining sutures, polydioxanone (PDS II, novartis.ethicon.com), polypropylene (Prolene, novartis.ethicon.com), polyglecaprone 25 (Monocryl, novartis.ethicon.com), lactomer, and glycomer (Biosyn, covidien.com), knots using 4 throws were similar to 6 throws. There were no significant differences between simple interrupted knots and knots at the beginning of simple continuous patterns; however, both were less likely to fail than knots at the end of simple continuous patterns. Knots tied by a board-certified surgeon were more secure than those tied by a fourth-year veterinary student.