Tying the Surgical Tie, Instrument Technique
With the short end away from you, position the forceps. Wrap the long end over the forceps, and then under. Pick up the end and pull tight to make the Half Knot. Position the forceps again and wrap the long end across them. Pick up the short end. Pull tight to complete the Square (Reef) Knot.
Surgical Tie, Instrument Technique
Uses: The Surgical Tie is a Square (Reef) Knot (ABOK # 460, p 75.) It is widely used in surgery although less secure than the Ligature Knot, which starts with an initial Double Throw Knot.
Techniques: This animation shows the end of the suture tied using an Instrument to form the knot. The disadvantage of the Instrument version of the Surgical Tie is the difficulty of keeping the ends taut during the tying process. Alternative techniques include the One Hand Technique, the Two Hand Technique, and the Surgical Slip Tie.
Learning and Teaching: Most right-handed students will prefer the Normal view and left-handed students the Mirror view. An Instructor sitting opposite a student may find it helpful to use the Inverted or Rotated views.
Repetition: The sequence shown in the animation is usually repeated to provide security. This precaution is appropriate because Square Knots are notoriously unreliable and because the completed knot is often hard to see – it could comprise a stack of slippery Half Hitches instead of the intended Square (Reef) Knot.
Reversing the Sequence: The animation shows the short end away from the surgeon. If the short end is towards the surgeon then start with Frames 9 to 13 to tie the first Half Knot followed by Frames 2 to 8 to complete the second Half Knot.
