Surgical Knot Tying Flashcards
What is the basic surgical knot?
Square knot
What is the first knot that should be mastered?
Instrument knot
What is a surgeon’s knot?
Double wrap throw followed by single square knot throws
How many (correct) throws are necessary to ensure that your knots do not slip?
As many as the attending surgeon wants
What are the guidelines for the number of minimal throws needed?
Depends on the material:
Silk (3)
Gut, Vicryl, Dexon, braided synthetics (4)
Nylon, polyester, polypropylene, PDS, Maxon (6)
How long should the ears of the knot be cut?
Some guidelines are:
Silk vessel ties: 1-2 mm
Abdominal fascia closure: 5 mm
Skin sutures, drain sutures: 5-10 mm
When should skin sutures be removed?
As soon as the wound has healed enough to withstand expected mechanical trauma.
Any stitch left in more than 10 days will leave a scar.
Guidelines:
Face (3-5 days), extremities (10 days), joints (10-14 days), back (14 days), abdomen (7 days)
How can strength be added to an incision during and after suture removal?
With Steri-Strips
In general, in which group of patients should skin sutures be left in longer than normal?
Patients on steroids
How should the sutures be cut?
Use the tips of the scissors to avoid cutting other tissues.
Try to remove the cut ends (less foreign material decreases risk of infection).
Rest the scissor-hand on the non-scissor-hand to steady.
How is an instrument knot tied?
Always start with a double wrap (surgeon’s knot), and then use a single wrap, pulling the suture in the opposite directions after every throw
Does a student need to know a one-hand tie?
No
What is the basic position for the two-hand tie?
“C” position, formed by the thumb and index finger.
The suture will alternate over the thumb and then the index finger for each throw.
