Evidence map›Paper›PMID 39340663›Full record

Observational studySurgery today2025

Comparative strength of ligature points achieved by various surgical knot-tying techniques: an observational study using Maxon™ monofilament sutures.

Shoichi Tsuzaka, Yuji Konishi, Kazuhiro Mino, Naotake Honma, Hideki Kawamura, Takuto Yoshida, Akinobu Taketomi

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In one paragraph

Observational study in Surgery today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Shoichi TsuzakaDepartment of Surgery, National Hospital Organization Hokkaido Medical Center, 1-1, 5-7, Yamanote, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan.
Yuji KonishiDepartment of Surgery, National Hospital Organization Hokkaido Medical Center, 1-1, 5-7, Yamanote, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan. blue-ocean@outlook.jp.
Kazuhiro MinoDepartment of Surgery, National Hospital Organization Hokkaido Medical Center, 1-1, 5-7, Yamanote, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan.
Naotake HonmaDepartment of Thoracic Surgery, National Hospital Organization Hokkaido Medical Center, 1-1, 5-7, Yamanote, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan.
Hideki KawamuraDepartment of Surgery, National Hospital Organization Hokkaido Medical Center, 1-1, 5-7, Yamanote, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan.
Takuto YoshidaSurgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada.
Akinobu TaketomiDepartment of Gastroenterological Surgery I, Hokkaido University Hospital, Kita-Ku, Kita 15, Nishi 7, Sapporo, Hokkaido, 060-8638, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical knot-tying requires careful selection of the appropriate technique for optimal outcomes; however, evidence is lacking about the common ligation techniques combining square and slip knots (combination knots). This study investigates the strength of a combination knot, compared with other techniques.

methodsIn this observational cohort study, we assessed the strengths of square, slip-granny, slip-reef, and combination knots using absorbable monofilament sutures, and compared them using ANOVA and a multilevel linear regression analysis. We also assessed the correlation between the number of throws and knot strength using Spearman's correlation analysis.

resultsAmong 80 ligatures, ANOVA indicated significant differences in knot strength among the techniques (p < 0.01). Multilevel linear regression showed that a combination knot was stronger than a slip knot (p < 0.01) and comparable to a square knot (p = 0.0721). Secondary analysis indicated that for combination knots, five throws could achieve sufficient knot strength.

conclusionCombination knots are as strong as square knots and stronger than slip knots, and thus present a reasonable option for surgical ligation.

Indexed as

SuturesSuture TechniquesTensile StrengthAnalysis of VarianceCohort StudiesHumansLigationLinear ModelsLigationSliding knotSlip knotSquare knotSuture technique

Identifiers

PMID39340663

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.