c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Introduction and Principles of Surgical Knots: 1

A D V E R T I S E M E N T

   
 

A surgical knot consists of a series of flat throws. The number of throws needed for security varies with the suture material. Three throws are sufficient for a braided material like silk, five throws are needed for stiff monofilaments like polypropylene and seven throws are necessary for the soft monofilament PTFE (Gore-tex). The smallest suture material capable of doing the job should be used to minimize foreign material in the wound.     

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Introduction and Principles of Surgical Knots: 2

A D V E R T I S E M E N T

   
 

Square knots (true knots) are the foundation of surgical knot tying and are the starting point in learning to tie. Variations with surgeons (friction) throws, slip knots an tension ties can be added later. The two-hand knot gives the best control and precision and should be mastered first.

Several basic principles listed below apply to all hand ties. Read through the principles before following the steps of the two hand and one hand ties, then reread them after your first practice runs. They will take on more meaning as you practice and will later become automatic if you follow the steps correctly.    

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Introduction and Principles of Surgical Knots: 3

A D V E R T I S E M E N T

   
 

The movements of the alternating throws can be followed dynamically using the movie and its slider bar. Details of individual steps are provided in storyboard form. Practice first with cord or very heavy (#5) braided suture material. When practicing, leave a relatively long length of suture between your hand and the knot and leave each throw loose as illustrated so that you can see when you put too much tension on the strands and disrupt your previous throw by loosening it or flipping it into a half hitch (slip knot)     

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This page was last modified on 6/1/1999.