![]() ![]() If this were necessary, the binding strand should be cut over the other constrictor strands to protect underlying tissue. Undoing it: Undoing a ligature is not anticipated – which is fortunate because the knot can be very hard to undo – cutting the knot is often the only option. However, just as a reminder, here is a pictorial of the classic method to tie a constrictor at the end of a rope, taken from my page of most useful knots. This particular technique quickly becomes a convenient instrument tie. Uses: The Constrictor Knot (ABOK 1188, p 216.) is uniquely suitable for use as a surgical ligature: it has superior binding properties, tightening smoothly and holding tight. This page focuses on ultra fast ways of tying constrictor knots (such as the coil-twist-loop and Sofia methods), and on variations on the constrictor, such as the boa knot and the myrtle hitch. In contrast to the double throw of the Surgical Half knot, the Constrictor Knot tightens more readily and is less prone to slip. This particular technique requires threading the forceps accurately to create the correct knot.Īdvantages: The additional pass around the vessel enhances the constriction effect. ![]() Our paper has generated interest and, as a result, the Royal College of Surgeons has kindly made it Available On Line.ĭisadvantages: The Constrictor Knot requires two passes around the vessel or pedicle and the knot itself requires learning. For our research we used a modification of his test bench to confirm that the Constrictor Knot is the most secure ligature by a large margin because of its ability to stay tight 1. ![]() But that also means it can be very difficult to undo easily. The knot has a binding ratchet effect, which is what makes it hold so well. But it is also potentially dangerous, particularly when tied in thin or even medium thickness cord. If you want an easy-to-untie version, try out the slipped constrictor knot. The constrictor knot is a great knot and one the first dozen or so people should learn. Research on the Constrictor Knot: Howard Taylor, a veterinary surgeon in Salisbury, England pioneered the use of the Constrictor Knot to ligate the uterine pedicle in a canine hysterectomy and prefers his Instrument Technique. Tips It may require careful dressing to distribute the tension all over the knot. Sliding the Constrictor Down the Forceps.Options: Four ways of tying it in surgery are compared: The Howard Instrument Technique may be the best way to facilitate tying it. Uses: The Constrictor Knot ( ABOK # 1188, p 216.) is uniquely suitable for use as a surgical ligature: it has superior binding properties, tightening smoothly and holding tight. ![]()
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