SCANNING ELECTRON-MICROSCOPIC STUDY OF MONOFILAMENT SUTURE KNOTS

Aims/Background-Interrupted corneal sutures are used routinely by many cataract and corneal surgeons. A slim compact knot facilitates burial and allows atraumatic suture removal, with decreased risk of wound de hiscence. The size and morphology of knots tied in different configura tions were investigated. Methods-10-0 nylon suture material was used t o tie knots on porcine corneal cataract sections using 2/1/1 (reef and granny), 3/1/1, and 1/1/1/1 (slip knot) configurations. 10-0 Mersilen e was used to tie 2/1/1 reef knots. Scanning electron micrographs of t he knots were digitised and their maximal lengths and widths estimated . In addition, the area of each knot was calculated and used as an ind ex of its volume. Results-2/1/1 reef knots were significantly smaller in all dimensions compared with the other knots (all p<0.03) except fo r the maximal width of 2/1/1 granny knots which were no wider than the 2/1/1 granny knots. The Mersilene knots were larger than the nylon on es. Conclusion-The use of 2/1/1 reef knots is recommended for corneal suturing.