Publication

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

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.

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Ontological neighbourhood
Related concepts (26)
Knot
A knot is an intentional complication in cordage which may be practical or decorative, or both. Practical knots are classified by function, including hitches, bends, loop knots, and splices: a hitch fastens a rope to another object; a bend fastens two ends of a rope to each another; a loop knot is any knot creating a loop; and splice denotes any multi-strand knot, including bends and loops. A knot may also refer, in the strictest sense, to a stopper or knob at the end of a rope to keep that end from slipping through a grommet or eye.
Knot theory
In topology, knot theory is the study of mathematical knots. While inspired by knots which appear in daily life, such as those in shoelaces and rope, a mathematical knot differs in that the ends are joined so it cannot be undone, the simplest knot being a ring (or "unknot"). In mathematical language, a knot is an embedding of a circle in 3-dimensional Euclidean space, . Two mathematical knots are equivalent if one can be transformed into the other via a deformation of upon itself (known as an ambient isotopy); these transformations correspond to manipulations of a knotted string that do not involve cutting it or passing it through itself.
Knot (mathematics)
In mathematics, a knot is an embedding of the circle S^1 into three-dimensional Euclidean space, R3 (also known as E3). Often two knots are considered equivalent if they are ambient isotopic, that is, if there exists a continuous deformation of R3 which takes one knot to the other. A crucial difference between the standard mathematical and conventional notions of a knot is that mathematical knots are closed — there are no ends to tie or untie on a mathematical knot.
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