"Good surgery is largely a matter of paying particular attention to little details."—J. M. T. Finney.
Through the centuries it has been known that twisted fibers are strong even though individually their component parts resist little tension. Notwithstanding, little attention has been paid to the matter of the twist in catgut suture material as it may affect the tensile strength and absorption of the strand and the reliability of the knot. It may safely be admited that some important and effective details in the practical use of catgut sutures and ligatures have been entirely overlooked. It is also to be admitted that surgeons have been rather careless in their use of catgut, and no doubt reckless with the truth in charging certain failures inadvertently to faulty material rather than to improper application.
The purpose of this article is to show how the twist and its variations can alter the
HORINE CF. CATGUT SUTURES AND LIGATURESGREATER EFFICACY ACHIEVED THROUGH OBSERVANCE OF CERTAIN DETAILS. Arch Surg. 1940;41(1):53-60. doi:10.1001/archsurg.1940.01210010056003