The strength of surgical knots involves a critical interplay between friction and elastoplasticity

Document Type

Article

Publication Date

6-7-2023

Abstract

Knots are the weakest link in surgical sutures, serving as mechanical ligatures between filaments. Exceeding their safe operational limits can cause fatal complications. The empirical nature of present guidelines calls for a predictive understanding of the mechanisms underlying knot strength. We identify the primary ingredients dictating the mechanics of surgical sliding knots, highlighting the previously overlooked but critical effect of plasticity and its interplay with friction. The characterization of surgeon-tied knots reveals the relevant ranges of tightness and geometric features. Using model experiments coupled with finite element simulations, we uncover a robust master curve for the target knot strength versus the tying pre-tension, number of throws, and frictional properties. These findings could find applications in the training of surgeons and robotic-assisted surgical devices.

Identifier

85161198488 (Scopus)

Publication Title

Science Advances

External Full Text Location

https://doi.org/10.1126/sciadv.adg8861

e-ISSN

23752548

PubMed ID

37285435

Issue

23

Volume

9

This document is currently not available here.

Share

COinS