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Training Program
MEDICAL STUDENTS

Surgeon's Knots or Friction Knot

The surgeon's or friction knot is recommended for tying Coated POLYSORB (ployglactin 910) suture, TICRON polyester fiber suture, MONOSOF nylon suture, SURGIDAC polyester fiber suture, SURGILON nylon suture and SURGIPRO polypropylene suture.

The surgeon's knot also may be performed using a one-hand technique in a manner analogous to that illustrated for the square knot one-hand technique.

Suture Names
Biosyn = Monocryl
Monosof = Ethilon
Polysorb = Vicryl
Sofsilk = Perma-Hand
Surgidac = Mersilene
Surgipro = Prolene
Ticton = Ethibond
   
  1. White strand placed over extended index finger of left hand and held in palm of left hand. Purple strand held between thumb and index finger of right hand.
Surgeon's Knot - Step 1
  1. Purple strand crossed over white strand by moving right hand away from operator at an angle to the left. Thumb and index finger of left hand pinched to form loop in the white strand over index finger.
Surgeon's Knot - Step 2
  1. Left hand turned inward by pronantion, and loop of white strand slipped onto left thumb. Purple strand grasped between thumb and index finger of left hand. Release right hand.
Surgeon's Knot - Step 3
  1. Left hand rotated by supination extending left index finger to pass purple strand through loop. Regrasp purple strand with right hand.
Surgeon's Knot - Step 4
  1. The loop is slid onto the thumb of the left hand by pronating the pinched thumb and index finger of left hand beneath the loop.
Surgeon's Knot - Step 5
  1. Purpel strand drawn left with right hand and again grasped between thumb and index finger of left hand.
Surgeon's Knot - Step 6
  1. Left hand rotated by supination extending left index finger to again pass purple strand through forming a double loop.
Surgeon's Knot - Step 7
  1. Horizontal tension is applied with the left hand toward and right hand away from the operator. This double loop must be placed in precise position for the final knot.
Surgeon's Knot - Step 8
  1. With thumb swung under white strand, purple strand is grasped between thumb and index finger of left hand and held over white strand with right hand.
Surgeon's Knot - Step 9
  1. Purple strand released. Left hand supinates to regrasp purple strand with index finger beneath the loop of the white strand.
Surgeon's Knot - Step 10
  1. Purple strand rotated beneath the white strand by supinating pinched thumb and index finger of left hand to draw purple strand through the loop. Right hand regraps purple strand to complete the second throw square.
Surgeon's Knot - Step 11
  1. Hands continue to apply horizontal tension with left hand away from and right hand toward the operator. Final tension on the final throw should be as nearly horizontal as possible.
Surgeon's Knot - Step 12

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