Knotting techniques

Knotting techniques

Knot tying is one of the most fundamental techniques in surgery and a poorly constructed knot may jeopardise an otherwise successful surgical procedure. The general principles behind knot tying are as follows: Figure 7.15 Figure 7.16 /uni25CF The knot must be tied firmly , but without strangulating the tissues. /uni25CF The knot must be as small as possible to minimise the amount of foreign material. /uni25CF The knot must be tightened without exerting any tension or pressure on the tissues being ligated, i.e. the knot should be bedded down carefully , only exerting pressure against counter-pressure from the index finger or thumb. /uni25CF The suture material must not be ‘sawed’ as this weakens the thread and cuts through delicate tissue like a cheese wire. /uni25CF The suture material must be laid square during tying; oth - erwise, tension during tightening may cause breakage or fracture of the thread. /uni25CF When tying an instrument knot, the thread should only be grasped at the free end, as gripping the thread with the needle holder can damage the material, resulting in break - age or fracture. /uni25CF The standard surgical knot is the reef knot with a third throw for security , although with monofilament sutures six throws are required for security . /uni25CF When added security is required, a surgeon’s knot using a two-throw technique is advisable to prevent slippage.

(b) (b) Mattress suture techniques. Subcuticular suture technique.

knot may be used for the final knot. /uni25CF When the suture is cut after knotting, the ends should be left about 1–2 /uni00A0 mm long to prevent unravelling. This is par ticularly important when using monofilament material. Knotting techniques

Knot tying is one of the most fundamental techniques in surgery and a poorly constructed knot may jeopardise an otherwise successful surgical procedure. The general principles behind knot tying are as follows: Figure 7.15 Figure 7.16 /uni25CF The knot must be tied firmly , but without strangulating the tissues. /uni25CF The knot must be as small as possible to minimise the amount of foreign material. /uni25CF The knot must be tightened without exerting any tension or pressure on the tissues being ligated, i.e. the knot should be bedded down carefully , only exerting pressure against counter-pressure from the index finger or thumb. /uni25CF The suture material must not be ‘sawed’ as this weakens the thread and cuts through delicate tissue like a cheese wire. /uni25CF The suture material must be laid square during tying; oth - erwise, tension during tightening may cause breakage or fracture of the thread. /uni25CF When tying an instrument knot, the thread should only be grasped at the free end, as gripping the thread with the needle holder can damage the material, resulting in break - age or fracture. /uni25CF The standard surgical knot is the reef knot with a third throw for security , although with monofilament sutures six throws are required for security . /uni25CF When added security is required, a surgeon’s knot using a two-throw technique is advisable to prevent slippage.

(b) (b) Mattress suture techniques. Subcuticular suture technique.

knot may be used for the final knot. /uni25CF When the suture is cut after knotting, the ends should be left about 1–2 /uni00A0 mm long to prevent unravelling. This is par ticularly important when using monofilament material. Knotting techniques

Knot tying is one of the most fundamental techniques in surgery and a poorly constructed knot may jeopardise an otherwise successful surgical procedure. The general principles behind knot tying are as follows: Figure 7.15 Figure 7.16 /uni25CF The knot must be tied firmly , but without strangulating the tissues. /uni25CF The knot must be as small as possible to minimise the amount of foreign material. /uni25CF The knot must be tightened without exerting any tension or pressure on the tissues being ligated, i.e. the knot should be bedded down carefully , only exerting pressure against counter-pressure from the index finger or thumb. /uni25CF The suture material must not be ‘sawed’ as this weakens the thread and cuts through delicate tissue like a cheese wire. /uni25CF The suture material must be laid square during tying; oth - erwise, tension during tightening may cause breakage or fracture of the thread. /uni25CF When tying an instrument knot, the thread should only be grasped at the free end, as gripping the thread with the needle holder can damage the material, resulting in break - age or fracture. /uni25CF The standard surgical knot is the reef knot with a third throw for security , although with monofilament sutures six throws are required for security . /uni25CF When added security is required, a surgeon’s knot using a two-throw technique is advisable to prevent slippage.

(b) (b) Mattress suture techniques. Subcuticular suture technique.

knot may be used for the final knot. /uni25CF When the suture is cut after knotting, the ends should be left about 1–2 /uni00A0 mm long to prevent unravelling. This is par ticularly important when using monofilament material.