Knotting Expert Club Knots: step by step

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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.

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.