Product Manual

During surgery, knot construction involves two distinct steps. The

purpose of the first step is to secure precise approximation of the

wound edges by advancing either a one-throw or a two-throw knot to

the wound surface. Once the throw or throws contact the wound, the

surgeon will have a preview of the ultimate apposition of the wound

edges. Ideally, the knotted suture loop should reapproximate the

divided wound edges without strangulating the tissue encircled by the

suture loop. If there is some separation of the wound edges, the one-

throw or two-throw knot can be advanced to reduce the size of the

suture loop and thereby bring the wound edges closer together.

When the surgeon forms a double-wrap throw, the first throw of the

surgeon’s knot square (2=1) can maintain apposition of the wound

edged by “locking” or temporarily securing it in place by reversing

the direction of pull on its “ears.” The “locked” double throw is not

Figure 8. Square knot (1=1) (A) is formed by first

passing the free suture end up through the suture

loop to create the first throw. The second throw

is formed by passing the free suture end down

through the suture loop. Square knot (1=1) (B)

is formed by passing the free suture end down

through the suture loop to create the first throw.

The second throw is formed by passing the free

suture end up through the suture loop.