Knots and Sutures!

Knot-Tying

 Suture knots can be tied with either an instrument (typically the needle holder) or your hands. There are three primary techniques described.

Two-Handed Tie

The two-handed tie is inconvenient and rarely worn. Holding one tag in each hand and intertwining them is how the suture is sewn together.

One-Handed Tie

The most prevalent hand-tying method is the one-handed knot. It is less time consuming and may be completed in a smaller space. The dominant hand's thumb and fingers are used to hold one end of the suture thread tag ('the long end'). The opposite side tag ('the short end') is a little further away from the first tag and runs in the same direction. The middle finger is folded and used to guide the short end of the tag around the long end before pulling the two tags apart.

Instrument Tie

The most common method for tying a suture knot is to use an instrument. The needle holder is wrapped around the long end. The beaks of the needle holders are then opened to grip the short end, which is pulled to make a tie. A 'throw' is one type of tie.

Sutures Knot

To make a knot, the suture thread tags are interlaced. The knot should be firm and tight, and it should not be positioned on the wound or incision line. During the healing process, it's critical that the knot stays tight and strong. Knot slippage or rupture during the healing process might be harmful to the wound. Because braided and uncoated sutures have a larger friction coefficient, knot security is often higher.

The knots used for surgical suturing are of a straightforward design. The square knot, surgeon's knot, and granny's knot are the most widely used. These three versions are remarkably close to one another, differing only in small details.

Square Knot / Reef knot

A square knot is one of the most basic knot designs. It entails a straightforward interweaving of the two threads. To make it secure, this 'half-hitch' knot (one 'throw' around the instrument) must be complemented with another comparable throw. The second hitch should ideally be in the opposite direction of the first, i.e. if the first throw is clockwise, the second should be anticlockwise.

More identical hitches in alternately shifting directions can be added to the original square knot made by a clockwise and counterclockwise hitch.

Surgeon's Knot

The first tangling is doubled in a surgeon's knot, which is a small modification of the square knot. This is done by tripling the first toss and wrapping the thread twice around the instrument. After that, a regular second throw in the opposite direction occurs.

Granny's knot

Two initial throws in the same way are made in the granny's knot, followed by a third toss in the opposite direction.

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