Knot-Tying
The Knot is the “weakest link” of the suture and therefore must be tied properly
Ways to do a Square Knot
2-handed (most control):
hand with standing end supinates and pronates to form loops
1-handed (faster):
hand with standing end is stationary throughout loop formation
Instrument (saves the suture):
standing end is wrapped around needle holder
4 common beginner errors
Too much motion in right hand (38%)
Failure to maintain consistent tension (17%)
Hands too close to knot (13%)
Failure to cross hands (7%)
Rogers, Regehr, and MacDonald (2002)
Dos & Don'ts
1. Failure to Rotate = Slip Knot
2. Failure to Cross = Granny Knot
1. Slip Knot 2. Granny Knot
Deep tie/ Delicate Tie/ Tension Tie
Deep: Square the knot & push it down flat with your index finger
Delicate: Pull with equal tension on both stands
Tension: Surgeon’s knot
To Cross or Not to Cross?
You should be able to knot-tie from any position!
1. Throws may start from either the crossed or uncrossed positions
2. If you start from the crossed position, rotate hands on second throw
3. If start from uncrossed position, rotate hands on first throw