🔍 Key Findings
- Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
- For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
- After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
- Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
- The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
- Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
- All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
- Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.
Simini Surgery Review Podcast
🔍 Key Findings
- Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
- For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
- After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
- Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
- The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
- Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
- All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
- Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.
Simini Surgery Review Podcast
Know What Matters in the Literature - and Why
We distill peer-reviewed surgical studies into clinically relevant summaries and
exam-style questions, so you can make informed decisions with confidence.
Free Access. No Spam. Just Smarter Surgical Learning
Multiple Choice Questions on this study
Access the full library of surgical summaries and exam-style questions.

