One-handed knot method: commonly used, simple and quick. Both hands can tie knots. Intraoperative application is the most extensive, so we should focus on mastering and practicing. Double-handed knotting method: Tie two cross knots in the same way with both hands, which is more convenient and reliable for deep or tissue tension. Suitable for surgical knotting. But it's tedious and time-consuming.
Instrument knotting method: generally, the left hand holds the suture needle and thread, and the right hand holds the needle holder or vascular clamp to tie the knot, which is used for continuous suture, deep surgery, short thread end and some fine operations. This method does not affect the field of vision and saves time. The disadvantage is that the suture is not easy to tighten when it is tightened.
Deep-hole knot: often used in deep pelvic cavity. After tying the first thread by hand or hemostatic forceps, tighten one thread, push the knot down with the other hand, and tie the second knot in the opposite direction.
Precautions: Before the first ligation, it is necessary to soak the wire harness in normal saline, and then perform ligation to increase the weight of the wire, facilitate the operation, increase the friction and make the wire knot firmly.
When tying the second knot, the direction of the first single knot and the second single knot of each flat knot cannot be the same, otherwise it will become a false knot and easy to slip off. Force your hands evenly, otherwise it may become a slippery knot and should be avoided. When tying a deep knot, press a finger near the knot and gradually tighten it so that the stress point of both hands is in line with the ligation point.
When tying a knot for the third time, you can't tie a knot after each single knot, otherwise you will cross and adjust the position. If there is entanglement, the silk thread will break easily after a little hard knot.