← Articles

Wood et al: Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model
Veterinary Surgery 4, 2024

🔍 Key Findings

  • Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
  • For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
  • After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
  • Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
  • The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
  • Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
  • All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
  • Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
‍We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
‍Mind trying that again?
← Articles

Wood et al: Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model
Veterinary Surgery 4, 2024

🔍 Key Findings

  • Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
  • For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
  • After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
  • Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
  • The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
  • Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
  • All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
  • Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.

Simini Surgery Review Podcast

Join Now to Access Key Summaries to more Veterinary Surgery Articles!
Log InSign Up

Multiple Choice Questions on this study

In Wood 2024 et al., on knot security and locking throws, which suture material showed greater holding strength?

A. PDS
B. Monosyn
C. Polyglactin
D. Glycomer
E. Polydioxanone

Answer: Monosyn

Explanation: Monosyn consistently outperformed PDS in all tested friction knot configurations.
In Wood 2024 et al., on knot security and locking throws, how did the failure mode differ between locking and non-locking constructs?

A. Both failed by breakage
B. Locking failed by slippage
C. Non-locking failed by breakage
D. Locking failed by breakage, non-locking by slippage
E. Both failed by stretch rupture

Answer: Locking failed by breakage, non-locking by slippage

Explanation: Non-locking knots failed by slipping, while locking versions broke the suture material.
In Wood 2024 et al., on knot security and locking throws, which knot type had the highest failure load regardless of locking status?

A. Miller's knot
B. Forwarder knot
C. Surgeon's knot
D. Constrictor knot
E. Strangle knot

Answer: Constrictor knot

Explanation: Constrictor knots demonstrated the greatest load resistance with and without locking throws.
In Wood 2024 et al., on knot security and locking throws, what was the effect of a single locking throw on holding strength?

A. No change
B. Reduced security
C. Varied by knot
D. Improved only PDS
E. Increased in all knots

Answer: Increased in all knots

Explanation: Adding a single locking throw increased the holding strength for all five knots tested.
In Wood 2024 et al., on knot security and locking throws, which knot had the poorest performance, especially without a locking throw?

A. Miller's knot
B. Surgeon's knot
C. Forwarder knot
D. Strangle knot
E. Constrictor knot

Answer: Forwarder knot

Explanation: Forwarder knot showed the lowest holding pressures, especially when unlocked.

Elevate Your Infection Control Protocol

Implement Simini Protect Lavage for superior, clinically-proven post-operative skin antisepsis and reduced infection risk.

Start Your Free Trial TodayStart Your Free Trial

Review More Key Summaries from this Veterinary Surgery Journal Issue

Ibrahim

 et al: 

Arterial supply to the scrotum: A cadaveric angiographic study

Larose

 et al: 

Comparing 3 mm and 5 mm laparoscopic liver biopsy samples in dogs

Moore

 et al: 

Association between divisional location and short-term outcome of liver mass resection in 124 dogs

Loh

 et al: 

Caudoventral hip luxation in 160 dogs (2003–2023): A multicenter retrospective case series

Welsh

 et al: 

Biomechanical analysis of orthogonal and unilateral locking plate constructs in a fracture gap model