Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture

Conclusion: The effect of excessive twisting on the mechanical properties of sutures is a previously unrecognised phenomenon. Surgeons should be aware that this can result in a decrease in suture strength and reduce the elasticity of the material, and therefore need to adapt their practice to reduce the torsional force placed on sutures.