ABSTRACT
TIP: Gut sutures do not fit into either category but behave more like monofilament sutures.
n Barbed versus nonbarbed (twisted or braided)2-5
• Addition of one-way barbs to maintain tension in knotless closure • Similar strength and postoperative complication profile to nonbarbed suture • Faster deployment than nonbarbed suture, but unable to backtrack and may trap fibers from
laparotomy sponges and surgical drapes • Range of absorbable and nonabsorbable barbed sutures available from multiple vendors
KNOT SECURITY The force necessary to cause a knot to slip n Knot security is proportional to the coefficient of friction and the ability of the suture to stretch. n More knot security means fewer throws are necessary to tie a reliable knot. n Braided sutures (e.g., silk, Vicryl) generally have better knot security than monofilament sutures
(e.g., Prolene, nylon).
