In Vitro Evaluation of the Aberdeen Knot for Continuous Suture Patterns with Large Gauge Suture.

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To evaluate the strength, size, and holding capacity of the Aberdeen knot compared to surgeon's and square knots using large gauge suture. In vitro mechanical study. Knotted suture. Aberdeen, surgeon's, and square knots were tested using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone under linear tension on a universal testing machine. Mode of failure and knot holding capacity (KHC) were recorded and relative knot security (RKS) was calculated as a percentage of KHC. Knot volume and weight were quantified by a digital micrometer and balance, respectively. Strength between number of throws, suture, suture size, and knot type were compared by ANOVA and post hoc testing. P≤.05 was considered significant. Aberdeen knots had higher KHC and RKS than surgeon's or square knots for all suture types and number of throws (P<.001). For all suture materials, none of the Aberdeen knots unraveled, but a portion of square and surgeon's knots with <7 throws did unravel (P=.101). Aberdeen knots had a smaller volume and weight than both surgeon's and square knots with equal numbers of throws (P<.001). The knot with the combined highest RKS and smallest size and weight was an Aberdeen knot with 4 throws using 3 USP polyglactin 910. The Aberdeen knots were stronger, more secure, and smaller than surgeon's and square knots for ending a continuous suture pattern. Clinically, the Aberdeen knot may be a useful alternative for completion of continuous patterns using large gauge suture, without sacrificing knot integrity.