Product Manual

Step 11.

Complete Withdrawal of the Free Suture End Down

Through the Suture Loop to Form Second,

Single-Wrap Throw

During withdrawal (arrow) of the free suture end through

the loop, it is held loosely between the tips of the left long

and ring fingers. This loose grasp (key pinch) between the

ulnar side of the distal phalanx of the left long finger and

the radial side of the distal phalanx of the left ring finger

does not allow constant tension to be maintained on this

suture end. For the left long and ring fingers to withdraw

(arrow) the entire suture end through the loop, the tips of

the left thumb and index finger must release the suture.

Step 12.

Advance Square Knot (1=1) to Wound Surface

The second throw is advanced and set against the first throw by

applying tension in a direction (arrows) perpendicular to that

of the wound. Advancement of the second throw is complete

when the second throw contacts the first throw to form a square

(1=1) knot. Ideally, the surgeon should be able to advance the

two-throw, square knot to allow meticulous approximation of the

wound edges. Once exact approximation of the wound edges is

accomplished, the surgeon will construct a knot with a sufficient

number of throws and 3mm cut “ears” so that knot security is

determined by knot breakage, rather than by slippage.