Knot Security of Polydioxanone and Polyamide in Vessel ligation: An In Vitro Study. Chen H1, Chen C2, Tai C2, Yeh L1. 1National Taiwan University Veterinary Hospital, Taipei City, Taiwan; 2National Taiwan University of Science and Technology, Taipei, Taiwan.
Vessel ligation is a basic but very crucial skill in surgical techniques. This study was designed to compare knot security of two suture materials on vessel ligation using an in vitro model. Hand-tie ligations were placed on a 3mm diameter latex tube of a vascular simulation system with an intraluminal pressure of 150 mmHg. Each ligation contained a surgeon’s knot followed by three additional throws, using USP 2-0 polyamide (Supramid) or polydioxanone (PDS). Leakage was defined as the distal sensor detecting an elevation of pressure over 0 mmHg. To simulate different skill levels of surgeons, groups were designed with time intervals between the first and the second throw at 0, 10, and 20 seconds, and with different tying forces of 6 N, 8 N, 10 N, 12 N and 14 N. As a result, all ligations were leaking with the tying forces equal or less than 8 N on both suture materials. No leakage (0%) was noted with the tying force of 14 N in both suture materials. There are no significant differences in leakage at any ligation forces or delay periods between groups. Polydioxanone and polyamide possess similar effect of ligation security in this study. Monofilament polydioxanone may serve as a choice for vessel ligation with no additional insecurity. However, these results are limited to in vitro tests and further in vivo study is necessary.