Influence of a single locking throw on the in vitro holding security of five friction throws.

OBJECTIVE

To compare the in vitro security of four different friction throws (square, surgeon's, Miller's, and strangle), with and without a locking throw, and a slip knot, on a vascular ligation model.

STUDY

DESIGN

Experimental study.

SAMPLE POPULATION: Nine groups with nine samples per group.

METHODS

Four throws (square, surgeon's, Miller's, and strangle), with and without a locking throw, and a square throw locked in slip knot fashion, were tested to measure leakage pressure.

RESULTS

The square and surgeon's throws leaked at a lower pressure than the Miller's and strangle throws (p < .0001). The leakage pressure was below physiologic arterial pressure for the square and the surgeon's throws. After the addition of a locking throw, the five knots leaked at a similar pressure (p = .5233) above physiologic arterial pressure.

CONCLUSION

Following the addition of a locking throw, all the constructs tested in this study leaked at a similar pressure. The leakage pressure for all knots exceeded physiologic arterial pressures.

CLINICAL SIGNIFICANCE: Any throw tested may be appropriate for secure vascular ligation if the initial throw is applied correctly.