Limiting oedema, ecchymosis and haemorrhage in septorhinoplasty with ice cooled swabs

Abstract

Handling surgical knots is recognised to reduce suture tensile strength. The loop-lock technique prevents knot sliding, maintaining optimal tension. Complete the first throw of a square knot (Fig 1). During the second throw, loop the suture around the needle holder, holding both loop limbs with the same hand (Fig 2). Proceed to grab the free end with the needle holder. Then pull the loop and the needle holder apart. The loop now sits on the first throw (Fig 3). Release the loop and complete the knot while maintaining tension on the needle holder and free end. This prevents knot sliding, maintaining optimum edge approximation.