Surgical knots have actually a wide variety of uses in surgery and also knot tie is an essential skill for every surgeon to know and also to be experienced in.

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A completed knot should be firm, such the slipping of the node is nearly impossible. However, excessive tension used through a node can reason damage come both the suture and the tissue, which can lead to bad wound healing and tissue necrosis. Each knot should be as small as possible, regarding reduce any foreign body reactions.

In this article, we shall look at the two major techniques for knot tying – the single handed tie and the tie at depth.


Single Handed node Tie

The square surgeons knot is the many reliable and also well-known for nearly all suture materials.

Procedure

Start through the quick thread encountering upwards and the lengthy thread encountering downwardsPick increase the finish of the brief thread v the together thumb and ring finger, v the remainder of the object passing over the l index and middle fingers. Choose up the end of the long thread through the R thumb and also index fingerBring increase the long thread through the R hand, come align beside the brief threadUsing the L center finger, whilst quiet holding the end in between L thumb and ring finger, happen the quick thread under and then end the lengthy threadPull the R hand upwards and also the l hand downwards, allowing the knot to remainder in position; adjust the anxiety of the knot together necessaryCome back upwards through the brief thread, by stop the end with the together thumb and also index finger. Choose up the long thread with the R thumb and also index finger and bring downwards, come align alongside the brief threadRepeat the exact same manoeuvre together before, passing the short thread under and also over the lengthy threadPull the together hand upwards and the R hand downwards, permitting the node to remainder in position; adjust the stress of the knot together necessaryRepeat the exact same manoeuvre as before with the short thread encountering upwards and also the long thread dealing with downwardsAdjust the last tension the the knot as necessary

Tying at Depth

Tying at depth is used for knot tie deep in ~ a human body cavity. The is important the node is tied firmly to stop slipping, whilst upwards push is avoided to prevent tearing that the tissue.

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Procedure

Start v the short thread facing upwards and the lengthy thread encountering downwardsOutside the the cavity, pick up the end of the quick thread through the together thumb and also ring finger, v the remainder of the thread passing over the together index and middle fingers. Pick up the finish of the lengthy thread through the R thumb and index fingerBring increase the lengthy thread v the R hand, to align next to the brief threadUsing the L center finger, whilst still holding the end in between L thumb and ring finger, happen the quick thread under and then end the lengthy threadPull the R hand upwards and also the l hand downwardsWhilst holding stress in the lengthy thread through the R hand outside the cavity, push the knot down through the L index finger past where the knot is required to lie inside the cavityCome back upwards through the quick thread, by stop the end with the together thumb and also index finger. Pick up the long thread through the R thumb and index finger and bring downwards, come align alongside the brief threadRepeat the very same manoeuvre as before, pass the brief thread under and over the long threadPull the R hand upwards and also the together hand downwardsWhilst holding stress in the lengthy thread with the R hand exterior the cavity, press the knot down through the L table of contents finger previous where the node is essential to lie inside the cavityRepeat the same manoeuvre as before with the brief thread dealing with upwards and the lengthy thread facing downwardsAdjust the last tension the the knot together necessary, by pushing past the knot.