Resumen de Comparison of volume, security, and biomechanical strength of square and Aberdeen termination knots tied with 4–0 polyglyconate and used for termination of intradermal closures in canine cadavers

Penny J. Regier, Kirk C. McGilvray, Daniel D Smeak, Kristin A. Coleman

• Objective—To compare volumes of square knots and Aberdeen knots in vitro and evaluate security of these knot types when used as buried terminal knots for continuous intradermal wound closures in canine cadavers.

  Design—Experimental study.

  Sample—24 surgically closed, full-thickness, 4-cm, epidermal wounds in 4 canine cadavers and 80 knots tied in vitro.

  Procedures—Continuous intradermal closures were performed with 4–0 polyglyconate and completed with a buried knot technique. Surgeon (intern or experienced surgeon) and termination knot type (4-throw square knot or 2 + 1 Aberdeen knot; 12 each) were randomly assigned. Closed wounds were excised, and a servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated for each sample; maximum load, displacement, stiffness, and mode of construct failure were recorded. Volumes of 2 + 1 Aberdeen (n = 40) and 4-throw square knots (40) tied on a suture board were measured on the basis of a cylindrical model.

  Results—Aberdeen knots had a mean smaller volume (0.00045 mm3) than did square knots (0.003838 mm3). Maximum load and displacement did not differ between construct types. Mean stiffness of Aberdeen knot constructs was greater than that of square knots.

  Conclusions and Clinical Relevance—The 2 + 1 Aberdeen knot had a smaller volume than the 4-throw square knot and was as secure. Although both knots may be reliably used in a clinical setting as the termination knot at the end of a continuous intradermal line, the authors advocate use of the Aberdeen terminal knot on the basis of ease of burying the smaller knot.