The purpose of this study was to determine the influence of the surgeo
n's tying technique on knot security using 0 and 2-0 monofilament and
multifilament nylon sutures. Using an Instron(R) Tensile Tester and a
portable tensiometer, knot security was achieved with these sutures us
ing four-throw square knots (1=1=1=1). After didactic and psychomotor
skill training, medical students were taught to construct the four-thr
ow square knot using either a two-hand tie or an instrument tie. Using
the portable tensiometer, their knot tying techniques were judged to
be superior to those used by surgeons. The surgeon's faulty technique
can easily be corrected by didactic information and psychomotor skill
training. (C) 1993 John Wiley & Sons, Inc.