Mechanical Performance of Nonabsorbable Monofilament Suture Materials Tied with Different Suturing Techniques Under Various Knot Configurations: An In Vitro Study

Abstract

This study compared widely used nonabsorbable and monofilament suture materials tied with three different configurations and two different suture techniques. Three suture materials (polytetrafluoroethylene, polypropylene, and nylon) were tied with either Laurell-Gottlow or the horizontal mattress suturing techniques using three different knot configurations: A (2 = 1 = 1 = 1 = 1), B (2 × 1 = 1 = 1 = 1), and C (1 × 2 = 1 = 1 = 1) on an experimental platform manufactured using a three-dimensional printer. Specimens underwent microtensile testing to determine maximum load failure and elongation rates at baseline and after 7 days of artificial saliva immersion. The Laurell-Gottlow yielded significantly lower elongation rates and higher failure load than the horizontal mattress suturing technique using nylon and polypropylene sutures at both time points (p < 0.001). Nylon had a significantly higher failure load and elongation than polypropylene and polytetrafluoroethylene at baseline for both suturing techniques and all three knot configurations (p < 0.001). Configuration C had low failure load values following immersion for all suture materials when using horizontal mattress suturing. Configuration A demonstrated superior failure load following the immersion period for all materials using both techniques. The polytetrafluoroethylene suture remained more stable over time. These findings indicate that the Laurell-Gottlow suturing technique with Configuration A provides better mechanical resistance to external forces when using nonabsorbable monofilament suture materials.