Knot Tying | Lecture Note

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

488

Pages:

2
Author:

Kyuwon J.

Knot tying ● Secures suture ligaments ○ If poorly tied, may lead to dehiscence, internal bleeding or other complications ○ Must develop in reliable knot techniques ● Throw ○ One crossing suture tails ■ Half knot ● Square knot ○ Opposite direction knot ○ Flat and secure ● Surgeon’s knot ○ First doubled (two wraps) prior to alterations ■ Prevention on loosening while the suture is on tensions ● Tumble ○ Knot slippage or twist due to unequal tensions ○ Slip knot Knot tying principles ● Maintaining opposite tension on both tails ● Keeping knots flat ● Correct number of throws ○ Silk = about 3 throws ○ Prolene = 7 throws ■ This is because of memory and slipperiness of prolene threads ● Cutting tail is also crucial ○ If too short knot unravels ○ Too long = foreign body reaction Clinical pearls ● Knot must be buries if possible ○ Will reduce in chance of infection and irritations ● Monofilaments such as nylon and prolene has risk on slippage therefore needs more throws to make it firm ● Braided structures such as silk and vicryl has greater friction, lesser throws are needed but there will be more tissue drags ○ Draw will cause tissue trauma necrosis and poor healing ○ Inflammation could happen exposing to greater risk of infection ■ Monofilaments or coated sutures will reduce in drags but is harder to have firm grip ■ Monofilament if applied in wrong way, may worsen the conditions Tips ● Maintaining constant visualization on the knot ● Excessive tension may break the suture damaging the tissue ○ Instrument ties must be used for precisions ○ Knot slide evenly