Mechanical Performance of Nonabsorbable Monofilament Suture Materials Tied with Different Suturing Techniques Under Various Knot Configurations: An In Vitro Study
Source abstract
Abstract
This study compared widely used nonabsorbable and monofilament suture materials tied with three different configurations and two different suture techniques. Three suture materials (polytetrafluoroethylene, polypropylene, and nylon) were tied with either Laurell–Gottlow or the horizontal mattress suturing techniques using three different knot configurations: A (2 = 1 = 1 = 1 = 1), B (2 × 1 = 1 = 1 = 1), and C (1 × 2 = 1 = 1 = 1) on an experimental platform manufactured using a three-dimensional printer. Specimens underwent microtensile testing to determine maximum load failure and elongation rates at baseline and after 7 days of artificial saliva immersion. The Laurell–Gottlow yielded significantly lower elongation rates and higher failure load than the horizontal mattress suturing technique using nylon and polypropylene sutures at both time points (p < 0.001). Nylon had a significantly higher failure load and elongation than polypropylene and polytetrafluoroethylene at baseline for both suturing techniques and all three knot configurations (p < 0.001). Configuration C had low failure load values following immersion for all suture materials when using horizontal mattress suturing. Configuration A demonstrated superior failure load following the immersion period for all materials using both techniques. The polytetrafluoroethylene suture remained more stable over time. These findings indicate that the Laurell–Gottlow suturing technique with Configuration A provides better mechanical resistance to external forces when using nonabsorbable monofilament suture materials.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Surgical Sutures and Adhesives · Shoulder Injury and Treatment · Orthopedic Surgery and Rehabilitation
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University-Cerrahpaşa, 34098 Istanbul, Turkey
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, 34295 Istanbul, Turkey
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Health and Technology University, 34445 Istanbul, Turkey
Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University-Cerrahpaşa, 34098 Istanbul, Turkey
References (51)
Show source-provided references
1. Suture Materials and Suture Techniques
2. Basic suture techniques for oral mucosa10.1902/cap.2011.110053 ↗
3. Treatment of intrabony defects by different surgical procedures. A literature review10.1902/jop.1998.69.3.303 ↗
4. Laurell–Gottlow suture modified by Sentineri for tight closure of a wound with a single line of sutures10.1016/j.bjoms.2015.08.005 ↗
5. Periodontal Regeneration with Enamel Matrix Derivative in the Management of Generalized Aggressive Periodontitis: A Case Report with 11-Year Follow-up and Literature Review10.4103/jispcd.JISPCD_119_18 ↗
6. The sausage technique using collagen membrane without autogenous bone graft: A case report10.32542/implantology.2021008 ↗
7. Alveolar Ridge Preservation after Tooth Extraction and Replacement with Fibre-reinforced Composite Bridge in a Young Patient: A Case Report10.21315/aos2022.17S1.CR01 ↗
8. Biomechanics of surgical knot security: A systematic review10.1097/JS9.0000000000000298 ↗
9. Suture materials—Current and emerging trends10.1002/jbm.a.35683 ↗
10. Coated sutures for use in oral surgery: A comprehensive review10.1007/s00784-025-06176-w ↗
11. Taylor, L., Saeinasab, M., Shahbazi, M.A., Zhang, X., Zhang, W., Nair, K., and Sefat, F. (2023). Smart sutures. Advanced Technologies and Polymer Materials for Surgical Sutures, Woodhead Publishing.10.1016/B978-0-12-819750-9.00012-7 ↗
12. Functional effects of delivering human mesenchymal stem cell-seeded biological sutures to an infarcted heart10.1089/biores.2016.0026 ↗
13. Characteristics of Suture Materials Used in Oral Surgery: Systematic Review10.1016/j.identj.2022.02.005 ↗
14. Pcheliakov, A.A., Diachkova, E.Y., Vasil’ev, Y.L., Svitich, O.A., Poddubikov, A.V., Evlashin, S.A., Volel, B.A., Bakhmet, A.A., Klochkova, S.V., and Velichko, E.V. (2023). Comparative Analysis of Mechanical Properties and Microbiological Resistance of Polyfilament and Monofila-ment Suture Materials Used in the Operation “Tooth Extraction”. Biomimetics, 8.10.3390/biomimetics8010129 ↗
15. Tensile strength of a surgeon’s or a square knot10.1016/j.jsurg.2010.06.007 ↗
16. Assessment of surgical trainees’ quality of knot-tying10.1016/j.jsurg.2012.07.002 ↗
17. Evaluation of the effect of 4 types of knots on the mechanical properties of 4 types of suture material used in small animal practice
18. Abellán, D., Nart, J., Pascual, A., Cohen, R.E., and Sanz-Moliner, J.D. (2016). Physical and mechanical evaluation of five suture materials on three knot configurations: An in vitro study. Polymers, 8.10.3390/polym8040147 ↗
19. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences10.3758/BF03193146 ↗
20. In Vitro Tensile Strength Study on Suturing Technique and Material10.1563/aaid-joi-D-16-00164 ↗
21. Minimum number of throws needed for knot security10.1016/j.jsurg.2010.11.001 ↗
22. Suture end length as a function of knot integrity10.1016/j.jsurg.2009.10.003 ↗
23. Knot Security 101: A Comprehensive Practical Review to Optimal Knot Configuration, Pulling Direction, Throw Count, and Tail Length
24. The Effect of Instrumentation on Suture Tensile Strength and Knot Pullout Strength of Common Suture Materials10.1016/j.jsurg.2015.08.011 ↗
25. Effect of Different MMP Inhibitors on the Bond Strength and Durability of an Etch-and-rinse and a Self-etch Adhesive
26. Collagen degradation by host-derived enzymes during aging10.1177/154405910408300306 ↗
27. Tissue response to suture materials implanted subcutaneously in a rabbit model10.1097/00006534-199712000-00023 ↗
28. Popularity of suture materials among residents and faculty members of a postdoctoral periodontology program10.1111/jicd.12032 ↗
29. Preference of Suture Specifications in a Selected Periodontal and Implant Surgeries in Turkey10.1055/s-0039-1688732 ↗
30. A systematic review and meta-analysis: Do absorbable or non-absorbable suture materials differ in cosmetic outcomes in patients requiring primary closure of facial wounds?10.1016/j.bjps.2018.08.027 ↗
31. Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients10.1097/00006534-200101000-00007 ↗
32. Knot performance of polypropylene sutures10.1002/(SICI)1097-4636(199623)33:3<187::AID-JBM8>3.0.CO;2-M ↗
33. Suture material in cosmetic cutaneous surgery10.1080/14764170601140062 ↗
34. Advances in suture material for obstetric and gynecologic surgery
35. Effect of tying conditions on the knot security of suture materials10.1002/app.28109 ↗
36. A biomechanical analysis of suture materials and their influence on a four-strand flexor tendon repair10.1016/j.jhsa.2005.03.011 ↗
37. Flexor tendon repair with a polytetrafluoroethylene (PTFE) suture material10.1007/s00402-018-03105-3 ↗
38. Tensile characteristics of PTFE sutures10.1016/0142-9612(88)90013-0 ↗
39. Knot security and tensile strength of suture materials10.1111/j.1532-950X.2013.12076.x ↗
40. Securing extraocular muscles in strabismus surgery: Biomechanical analysis of muscle imbrication and knot tying technique10.1016/j.jaapos.2018.07.356 ↗
41. Some biomechanical considerations of polytetrafluoroethylene sutures10.1001/archsurg.1990.01410170095020 ↗
42. Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review10.3390/surgeries5020029 ↗
43. Mechanical properties of suture materials in general and cutaneous surgery10.1002/jbm.b.33171 ↗
44. A Comparison of Two Monofilament Suture Materials for Repair of Partial Flexor Tendon Lacerations: A Controlled In-vitro Study10.1142/S0218810417500034 ↗
45. All monofilament knots assume sliding conformation in vivo10.1111/dsu.12112 ↗
46. Comparison of tensile and knot security properties of surgical sutures10.1007/s10856-007-3114-6 ↗
47. Thermodynamic characteristics of the aliphatic polyamide crystal structures: Enhancement of nylon 66α, 610α and 77γ polymers10.1016/j.heliyon.2023.e21042 ↗
48. Why Teflon is so slippery while other polymers are not10.1103/PhysRevE.107.024801 ↗
49. Zhou, P., Tian, J., Li, C., and Tang, Z. (2022). Comparative Study of Durability Behaviors of Thermoplastic Polypropylene and Thermosetting Epoxy Exposed to Elevated Temperature, Water Immersion and Sustained Bending Loading. Polymers, 14.10.3390/polym14142953 ↗
50. The effect of saliva and oral intake on the tensile properties of sutures: An experimental study10.1097/01.sap.0000245071.98517.8c ↗
51. Tullis, J.L. (2020). Influence of Suture Technique on Ridge Dimensions and Keratinized Tissue After Alveolar Ridge Preservation: A Pilot Study. [Doctoral Dissertation, University of Missouri-Kansas City].