PubMed · 15433309
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M FISCHER. 1950. [Catgut].. https://pubmed.ncbi.nlm.nih.gov/15433309/
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OBJECTIVE: This study was undertaken to evaluate the integrity of the loop-to-strand knot when tied with square and nonidentical sliding knots. STUDY DESIGN: The synthetic absorbable monofilament suture poliglecaprone 25 in 0 and 2-0 suture gauges was used in this experiment. For each suture gauge, 3 groups of knots were tested: (1) single strand-to-single strand, flat square knot, (2) loop-to-single strand, flat square knot, and (3) loop-to-single strand, nonidentical sliding knot. All knots were tied with 6 throws. The proportion of knots becoming untied was compared among the 3 groups for each suture gauge. Ultimate load required to untie or break knots within each group was also evaluated. RESULTS: The loop-to-strand knot performed well in both suture gauges tested as long as it was tied with a flat square knot. The loop-to-strand knot tied with a nonidentical sliding knot had an unacceptably high failure rate. CONCLUSION: The loop-to-strand termination of a continuous suture may be acceptable when tied with a 6-throw flat square knot but not acceptable if tied with sliding knots.
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OBJECTIVE: We conducted a randomized trial to evaluate the healing characteristics of chromic versus fast-absorbing polyglactin 910. METHODS: Laboring women were randomly assigned to chromic or fast-absorbing polyglactin for perineal repairs. Subjects were evaluated at 24-48 hours, 10-14 days, and 6-8 weeks to assess perineal and uterine pain, analgesic use, presence of residual suture, and wound dehiscence. RESULTS: Between April 2002 and January 2003, 1,361 subjects were randomly assigned. Two thirds of women in each group (459 fast-absorbing polyglactin and 449 chromic) required sutures for perineal repairs. Women were evaluated according to randomization assignment. Overall, 794 (87%) of subjects received the appropriate allocated suture to repair a perineal laceration (399 of 459, 86.9% fast-absorbing polyglactin 910; 395 of 449, 88% chromic catgut). At 24-48 hours, there was a statistically significant reduction in uterine cramping pain (25% versus 34%; P =.006) in subjects randomly assigned to fast-absorbing polyglactin. At 10-14 days, there were no statistically significant differences between the groups. At 6-8 weeks there was, again, a statistically significant reduction in uterine cramping pain (1% versus 4%; P =.017) and a statistically significant decrease in analgesic use (5% versus 10%; P =.048) in subjects randomly assigned to fast-absorbing polyglactin. Finally, at 6-8 weeks postpartum there was no difference in residual suture (2 of 175 versus 2 of 134; P =.802) or wound breakdowns (4 of 175 versus 3 of 134; P =.959) for fast-absorbing polyglactin 910 and chromic catgut, respectively. CONCLUSION: Our data suggest that fast-absorbing polyglactin 910 and chromic elicit similar postpartum perineal discomfort. In contrast to previous studies evaluating standard polyglactin, our trial demonstrated that fast-absorbing polyglactin rarely requires late removal and has a similar wound breakdown profile as compared with chromic. LEVEL OF EVIDENCE: I