Measurement of surgical knot failure forces: design and validation
EAES Academy. Rahimi M. 07/05/22; 366542; P285
Mr. Masie Rahimi
Contributions
Contributions
Abstract
Measurement of surgical knot failure forces: design and validation
Aims
Surgical wound suturing and open surgical knot tying are essential basic surgical skills. Wound healing after suturing heavily relies on the quality of the suture and strength of the surgical knot. For an efficient training curriculum, with a high learning efficiency, an appropriate objective assessment with feedback is also paramount. To assess the quality of a surgical suture, a new and user friendly knot testing tool was developed and tested.
Methods
A new pinned “Hook in Force Measuring (HFM)” device was created to test and evaluate surgical sutures. The pins of the HFM were hooked underneath the surgical suture and spread until the knot started to slip (Figure 1, A). The force sensor in the HFM consisted of a spring steel sheet, enabling the handle to deform elastically when the pliers were used to open the suture. The amount of deformation was proportional to the load needed to open the suture. The deformation is measured by a hall sensor and permanent magnet combination. In addition, the HFM opening angle α is measured using a potentiometer (Figure 1).
After calibration with free weights and a calibre, the HFM device was tested on 3 surgical suture knots performed by an experienced surgeon. Surgical suture 1 was made according to the standards but not tightened, suture 2 was made according to the standard and tightened at the end and suture 3 was made loosely and not tightened at all. Using the force and angle data, the input energy until knot failure E was determined by calculating the integral of the moment arm (M=Fd) over the pliers opening angle α with F being the opening force as a function of α and d was the moment arm.
E=∫Fd dα
Results/discussion
The surgeon had no problem using the tool and was able to test the 3 sutures within a minute. Figure 2 showed the force-angle relation of the 3 measured suture knots. It becomes clear from the data that surgical suture 3 showed the most slip, surgical suture 2 started to unraffle and surgical suture 1 showed an increase in angle opening resulting in a higher loop force. The instance of knot failure is defined as the point where the maximum force occurs and is denoted with an asterisk. The input energy until knot failure was 0.26J, 0.31J, and 0.70J for surgical suture 1, 2 and 3 respectively.
Conclusions
The HFM proved to be an user friendly and useful tool to measure knot dynamics, failure force and input energy. The maximum force can be used in suture knot quality assessment and training of basic suturing skills.
Aims
Surgical wound suturing and open surgical knot tying are essential basic surgical skills. Wound healing after suturing heavily relies on the quality of the suture and strength of the surgical knot. For an efficient training curriculum, with a high learning efficiency, an appropriate objective assessment with feedback is also paramount. To assess the quality of a surgical suture, a new and user friendly knot testing tool was developed and tested.
Methods
A new pinned “Hook in Force Measuring (HFM)” device was created to test and evaluate surgical sutures. The pins of the HFM were hooked underneath the surgical suture and spread until the knot started to slip (Figure 1, A). The force sensor in the HFM consisted of a spring steel sheet, enabling the handle to deform elastically when the pliers were used to open the suture. The amount of deformation was proportional to the load needed to open the suture. The deformation is measured by a hall sensor and permanent magnet combination. In addition, the HFM opening angle α is measured using a potentiometer (Figure 1).
After calibration with free weights and a calibre, the HFM device was tested on 3 surgical suture knots performed by an experienced surgeon. Surgical suture 1 was made according to the standards but not tightened, suture 2 was made according to the standard and tightened at the end and suture 3 was made loosely and not tightened at all. Using the force and angle data, the input energy until knot failure E was determined by calculating the integral of the moment arm (M=Fd) over the pliers opening angle α with F being the opening force as a function of α and d was the moment arm.
E=∫Fd dα
Results/discussion
The surgeon had no problem using the tool and was able to test the 3 sutures within a minute. Figure 2 showed the force-angle relation of the 3 measured suture knots. It becomes clear from the data that surgical suture 3 showed the most slip, surgical suture 2 started to unraffle and surgical suture 1 showed an increase in angle opening resulting in a higher loop force. The instance of knot failure is defined as the point where the maximum force occurs and is denoted with an asterisk. The input energy until knot failure was 0.26J, 0.31J, and 0.70J for surgical suture 1, 2 and 3 respectively.
Conclusions
The HFM proved to be an user friendly and useful tool to measure knot dynamics, failure force and input energy. The maximum force can be used in suture knot quality assessment and training of basic suturing skills.
Measurement of surgical knot failure forces: design and validation
Aims
Surgical wound suturing and open surgical knot tying are essential basic surgical skills. Wound healing after suturing heavily relies on the quality of the suture and strength of the surgical knot. For an efficient training curriculum, with a high learning efficiency, an appropriate objective assessment with feedback is also paramount. To assess the quality of a surgical suture, a new and user friendly knot testing tool was developed and tested.
Methods
A new pinned “Hook in Force Measuring (HFM)” device was created to test and evaluate surgical sutures. The pins of the HFM were hooked underneath the surgical suture and spread until the knot started to slip (Figure 1, A). The force sensor in the HFM consisted of a spring steel sheet, enabling the handle to deform elastically when the pliers were used to open the suture. The amount of deformation was proportional to the load needed to open the suture. The deformation is measured by a hall sensor and permanent magnet combination. In addition, the HFM opening angle α is measured using a potentiometer (Figure 1).
After calibration with free weights and a calibre, the HFM device was tested on 3 surgical suture knots performed by an experienced surgeon. Surgical suture 1 was made according to the standards but not tightened, suture 2 was made according to the standard and tightened at the end and suture 3 was made loosely and not tightened at all. Using the force and angle data, the input energy until knot failure E was determined by calculating the integral of the moment arm (M=Fd) over the pliers opening angle α with F being the opening force as a function of α and d was the moment arm.
E=∫Fd dα
Results/discussion
The surgeon had no problem using the tool and was able to test the 3 sutures within a minute. Figure 2 showed the force-angle relation of the 3 measured suture knots. It becomes clear from the data that surgical suture 3 showed the most slip, surgical suture 2 started to unraffle and surgical suture 1 showed an increase in angle opening resulting in a higher loop force. The instance of knot failure is defined as the point where the maximum force occurs and is denoted with an asterisk. The input energy until knot failure was 0.26J, 0.31J, and 0.70J for surgical suture 1, 2 and 3 respectively.
Conclusions
The HFM proved to be an user friendly and useful tool to measure knot dynamics, failure force and input energy. The maximum force can be used in suture knot quality assessment and training of basic suturing skills.
Aims
Surgical wound suturing and open surgical knot tying are essential basic surgical skills. Wound healing after suturing heavily relies on the quality of the suture and strength of the surgical knot. For an efficient training curriculum, with a high learning efficiency, an appropriate objective assessment with feedback is also paramount. To assess the quality of a surgical suture, a new and user friendly knot testing tool was developed and tested.
Methods
A new pinned “Hook in Force Measuring (HFM)” device was created to test and evaluate surgical sutures. The pins of the HFM were hooked underneath the surgical suture and spread until the knot started to slip (Figure 1, A). The force sensor in the HFM consisted of a spring steel sheet, enabling the handle to deform elastically when the pliers were used to open the suture. The amount of deformation was proportional to the load needed to open the suture. The deformation is measured by a hall sensor and permanent magnet combination. In addition, the HFM opening angle α is measured using a potentiometer (Figure 1).
After calibration with free weights and a calibre, the HFM device was tested on 3 surgical suture knots performed by an experienced surgeon. Surgical suture 1 was made according to the standards but not tightened, suture 2 was made according to the standard and tightened at the end and suture 3 was made loosely and not tightened at all. Using the force and angle data, the input energy until knot failure E was determined by calculating the integral of the moment arm (M=Fd) over the pliers opening angle α with F being the opening force as a function of α and d was the moment arm.
E=∫Fd dα
Results/discussion
The surgeon had no problem using the tool and was able to test the 3 sutures within a minute. Figure 2 showed the force-angle relation of the 3 measured suture knots. It becomes clear from the data that surgical suture 3 showed the most slip, surgical suture 2 started to unraffle and surgical suture 1 showed an increase in angle opening resulting in a higher loop force. The instance of knot failure is defined as the point where the maximum force occurs and is denoted with an asterisk. The input energy until knot failure was 0.26J, 0.31J, and 0.70J for surgical suture 1, 2 and 3 respectively.
Conclusions
The HFM proved to be an user friendly and useful tool to measure knot dynamics, failure force and input energy. The maximum force can be used in suture knot quality assessment and training of basic suturing skills.
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