Saphenous vein bypass conduits preparation with 4 0 silk ties Made with Clipchamp скачать в хорошем качестве

Saphenous vein bypass conduits preparation with 4 0 silk ties Made with Clipchamp

Saphenous vein bypass conduits preparation with 4-0 silk ties The preparation of saphenous vein bypass conduits using 4-0 silk ties is a delicate procedure that demands precision and skill to ensure optimal short- and long-term patency. It is important to note that hand ties are preferred over instrument ties as they enable the proper force and tension necessary to create secure knots. The standard square knot is considered the gold standard as it locks suture strands together and provides maximum contact surface area. However, different knot configurations exhibit varying holding strengths, properties, and mechanisms of knot failure. Therefore, meticulous preparation of the graft and tie knots to branch approximately 1 to 2 millimeters distally to the graft using 4-0 silk with a Jay mosquito clamp is necessary to ensure appropriate support and assistive measures. Knots are generally left with a 3-6 mm tails depending on program preference. The security of a knot relies on various factors, including suture material, tying technique, and the number of throws. Research has suggested that the surgeon's knot provides greater security than square and sliding knots. A surgeon's or square knot typically requires at least four throws, whereas sliding knots usually require at least five throws. After five throws, knot security does not improve, and only two throws are never indicated. While ambidextrous skills are advantageous for tie-tying, the one-handed tie is commonly used due to increased speed. Nonetheless, the two-handed technique affords greater control of tension across knots and increases knot security. Practicing without ego and with the right motivation can foster ambidextrous skills through thousands of practice sessions. To prepare saphenous vein bypass conduits with 4-0 silk ties, a combination of purpose, finger position, tension, rhythm, and, above all, efficiency is necessary. By combining expertise, proper tools, and meticulous techniques, saphenous vein bypass conduits with 4-0 silk ties can achieve both short- and long-term patency.