Quiz Publications Add case
Basic Surgical Technique, Knots and Sutures

Instrument tie

David Salim med. student, Christoffer Bing Madsen med. student, Magnus Avnstorp MD.

Most surgical knots in skin/tissue reconstruction are conducted by making an instrument tie.

  1. Grasp leading end of suture material between thumb and index finger
  2. Bring the needle driver between leading and trailing strand of the suture
  3. Wrap needle driver twice around the leading strand
  4. Grasp the trailing end of the suture
  5. Pull the strands in opposite directions perpendicular to the wound edge
  6. Release trailing end by the needle driver
  7. Now wrap needle driver once around the leading strand and grasp the trailing strand while moving hands in opposite directions
  8. Do the 7th step once more, and you are done.

Video of instrument tie coming soon