From the Research
Tying prolene (polypropylene) to itself is generally not recommended in surgical procedures due to its tendency to slip and potentially lead to knot failure. Prolene sutures are monofilament, non-absorbable synthetic sutures that have a tendency to slip when tied to themselves, potentially leading to knot failure, as shown in a study that found fixing the first throw of a monofilament suture significantly reduced the ultimate failure load of polypropylene sutures 1. When securing prolene, surgeons typically use more knot throws than with other suture materials, usually 5-7 square knots rather than the standard 3-4, to prevent knot slippage. Alternatively, many surgeons prefer to use a different suture material for securing prolene, such as silk or vicryl, which provides better knot security.
Some key points to consider when working with prolene sutures include:
- The slippery nature of prolene stems from its physical properties that give it excellent tensile strength and minimal tissue reactivity, but also make it challenging to maintain knot security 2.
- A study found that Vicryl had the greatest knot security, followed by chromic gut, nylon, and silk, suggesting that vicryl may be a good alternative for securing prolene 3.
- The use of more knot throws or alternative suture materials can help prevent knot slippage and ensure the security of the suture, which is particularly important in vascular procedures or other situations where suture failure could have serious consequences.
- Despite its limitations, prolene remains valuable in many surgical applications due to its durability and minimal tissue reaction, as shown in a study that found polypropylene sutures gave superior knot performance to PDS, but only the polypropylene gave equivalent ease of manipulation 4.
Overall, while prolene has its limitations, it can still be a valuable tool in surgical procedures when used properly and with caution, taking into account its tendency to slip and the need for additional knot throws or alternative suture materials to ensure knot security.