Mar 27, 2021

Recently, there are many medical films and TV programs in China, such as "The great pediatrician" and "My little luck". At the same time, a popular medical term is "surgical knot". So what is surgical knot? When it comes to surgical knots, it's natural to start with surgical sutures. Different types of surgical sutures have different knotting methods.

Types of knots: square knot, surgical knot and triple knot

1. Square knot: also known as flat knot, is the most commonly used in surgery. It is composed of two single knots with opposite directions (the first knot and the second knot have opposite directions). It is the main ligation method in surgery. It is not easy to slip. It is mainly used for ligation of skin, adipose tissue and small blood vessels.

2. Surgical knot: the first knot is wound twice, which increases the friction between the sutures. When the second knot is wound, it is not easy to slip and loosen, which is more reliable.

3. Triple knot: it is to add a knot on the basis of the square knot, a total of three knots, which are relatively firm and also called strengthening knot.

In the process of knotting, there are two kinds of mistakes: false knot and sliding knot. It is easy to form slipknot if the force of both hands is uneven, and false knot if the direction of knot is wrong.

Knot method: single hand knot, two hand knot, instrument knot

1. One hand knot: It is simple and rapid, can be carried out by both hands, and is widely used, but it is easy to form a sliding knot if it is not operated properly. When tying a knot, one hand holds the suture and the other hand acts to tie the knot. The main actions are thumb, food and middle fingers. All the movements such as "holding the thread", "picking up the thread" and "hooking the money" must be performed near the end of the finger, so as to achieve rapid and effective. Pay attention to the direction of the line when making knots. Hold a short right hand thread, such as the knot. This method is suitable for ligation of various parts.

2. Two hand knot: It is more reliable than single hand knotting, and is not easy to slip. The method of two hand knotting is more complex than single hand knotting. In addition to general ligation, it is more reliable and convenient for deep or tissue tension suture ligation. This method is suitable for ligation and suture of deep tissue.

3. Instrument knotting: It is simple and easy to learn to knot with vascular forceps or needle holder. It is suitable for ligation in deep and narrow space operation, or when the suture is too short and it is difficult to knot by hand. The utility model has the advantages of saving the operation suture, saving the threading time, and not hindering the vision.

The disadvantage is that when there is tension suture, the first knot is easy to loosen and slip, and it needs assistant to tie tightly. The way to prevent slippage is to change the direction of the knot or an assistant.

Precautions for surgical suture knotting:

1. When tying knots, the two hand force points and the three ligation points should be in a straight line. If there is a certain angle between the three points, it is easy to make the ligation line fall off when the force is tightened.

2. When tightening the knot, the two hands are evenly forced. If one hand is loose and the other hand is tight, it is easy to form a sliding knot.

3. When tying knots, the distance between hands is not easy to be too far off-line, especially when deep tying knots, it is best to extend the index fingers of both hands to the knot.

4, when the surgical suture is cut, the operator will bring the double line tail slightly. The assistant slides to the knot with the slightly opened scissors tip along the tight ligation line, then slightly tilts with the scissors, cutting and retaining the length of the thread.