Материал: surgical knot tying manual covidien

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VIII. two-hand tie techniques — surgeon’s knot square (2=1) formation of the first, double-wrap throw (cont’d)

Step 9.

Pass Free Suture End

Down Through the Suture Loop to Form Double-Wrap,

First Throw

The free suture end grasped between the tips of the left thumb and index finger is passed down (arrow) through the suture loop. The right hand releases its suture end so that it can be withdrawn

through the suture loop. As the free suture end passes through the loop, it is regrasped by the right hand to withdraw it through the suture loop.

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Step 10.

Advance Double-Wrap, First Throw to Wound Surface

With the suture ends grasped in the palms of the surgeon’s hands, the tips of the index fingers and thumbs position the suture ends in a direction (arrows) perpendicular to that of the wound. The surgeon applies constant tension to the suture ends, which advances the double-wrap, first throw of the surgeon’s knot square to the surface of the wound. Advancement of the first throw is complete when the divided edges of the mid-portion of the wound are approximated.

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VIII. two-hand tie techniques — surgeon’s knot square (2=1) formation of the second throw

Step 11.

Begin Formation of the Second Suture Loop

The dorsum of the tip of the left thumb is passed under (arrow) its suture end in order to direct it beneath the other suture end that is held by the right hand. During formation of the second throw, constant tension is applied to the suture ends to maintain wound approximation.

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