Knotting Expert Club Knots: step by step

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B. Braun VetCare
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Wound Management Closure Technology | B. Braun VetCare
Surgical Sutures Veterinary Medicine
Knotting Expert Club
Knots: step by step
Surgeon’s Knot (Common technique)

First throw

Surgeon´s Knot

Surgeon’s Knot (Common technique) 

In cases when tissues are under some tension, extra strength is needed so that the knot does not slide. This extra strength is accomplished by looping a thread twice around the other. This increases the friction between both strands and therefore a stronger knot is obtained.
This knot will never be performed on skin, as there should never be tension on this layer. In cases where a certain tension is present, subcutaneous layers have to be sutured first to release the tension on the surface.

01_Surgeons Knot Common technique First throw
Place white strand over extended index finger of left hand. Hold the rest of the thread in left palm. Place blue strand over extended left thumb and hold rest of blue strand in right hand.
02_Surgeons Knot Common technique First throw
Approximate left index and thumb fingers.
03_Surgeons Knot Common technique First throw
Pronate left hand until thumb haas passed below white strand.
04_Surgeons Knot Common technique First throw
Hold blue strand between left index finger and left thumb.
05_Surgeons Knot Common technique First throw
Push blue strand with left index finger and pass it under white strand.
06_Surgeons Knot Common technique First throw
Pass the rest of the blue strand under white strand.
07_Surgeons Knot Common technique First throw
Approximate left index and thumb fingers.
08_Surgeons Knot Common technique First throw
Pronate left hand until thumb haas passed below white strand.
09_Surgeons Knot Common technique First throw
Hold blue strand between left index finger and left thumb.
10_Surgeons Knot Common technique First throw
Push blue strand with left index finger and pass it under white strand.
11_Surgeons Knot Common technique First throw
Pass the rest of the blue strand under white strand.
12_Surgeons Knot Common technique First throw
The first throw of a surgeon's knot should be obtained.
01_Surgeons Knot Common technique First throw
Place white strand over extended index finger of left hand. Hold the rest of the thread in left palm. Place blue strand over extended left thumb and hold rest of blue strand in right hand.
02_Surgeons Knot Common technique First throw
Approximate left index and thumb fingers.
03_Surgeons Knot Common technique First throw
Pronate left hand until thumb haas passed below white strand.
04_Surgeons Knot Common technique First throw
Hold blue strand between left index finger and left thumb.
05_Surgeons Knot Common technique First throw
Push blue strand with left index finger and pass it under white strand.
06_Surgeons Knot Common technique First throw
Pass the rest of the blue strand under white strand.
07_Surgeons Knot Common technique First throw
Approximate left index and thumb fingers.
08_Surgeons Knot Common technique First throw
Pronate left hand until thumb haas passed below white strand.
09_Surgeons Knot Common technique First throw
Hold blue strand between left index finger and left thumb.
10_Surgeons Knot Common technique First throw
Push blue strand with left index finger and pass it under white strand.
11_Surgeons Knot Common technique First throw
Pass the rest of the blue strand under white strand.
12_Surgeons Knot Common technique First throw
The first throw of a surgeon's knot should be obtained.

Second throw

Surgeon’s Knot_Second throw

Surgeon’s Knot (Common technique) 

Once the first throw of the Surgeon’s knot is completed, a simple knot will be added to complete a Surgeon’s knot.
Surgeons will normally add a total of 2-3 simple knots (depending on suture’s material) to achieve a satisfactory level of security.

01_Surgeons Knot Second throw
Place left thumb over white strand and then place blue strand over white strand.
02_Surgeons Knot Second throw
Approximate left index finger and left thumb.
03_Surgeons Knot Second throw
Pass left index finger and thumb under white strand.
04_Surgeons Knot Second throw
Hold blue strand between left index finger and thumb.
05_Surgeons Knot Second throw
Use left thumb to push blue strand under white strand.
06_Surgeons Knot Second throw
Pass the rest of blue strand under white strand and hold blue strand with right hand.
07_Surgeons Knot Second throw
Rotate your hands and tighten both strands (white opposite to you, blue towards you).
08_Surgeons Knot Second throw
A surgeon's knot should be obtained.
01_Surgeons Knot Second throw
Place left thumb over white strand and then place blue strand over white strand.
02_Surgeons Knot Second throw
Approximate left index finger and left thumb.
03_Surgeons Knot Second throw
Pass left index finger and thumb under white strand.
04_Surgeons Knot Second throw
Hold blue strand between left index finger and thumb.
05_Surgeons Knot Second throw
Use left thumb to push blue strand under white strand.
06_Surgeons Knot Second throw
Pass the rest of blue strand under white strand and hold blue strand with right hand.
07_Surgeons Knot Second throw
Rotate your hands and tighten both strands (white opposite to you, blue towards you).
08_Surgeons Knot Second throw
A surgeon's knot should be obtained.