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When tying knots using the instrument- or hand-tie techniques, surgeons must be able to lengthen or shorten suture strands. Gathering and sliding maneuvers are finger movements used to adjust the length of the suture strands. Both gathering and sliding can be combined to achieve the optimal working distance when tying knots. In this topic, you will learn how to perform these finger maneuvers. In the next topic, you will apply these maneuvers as you begin to practice knot-tying techniques.
When tying knots, it is important to grasp the suture at a comfortable working distance from the knot.  To achieve these optimal working distances, the surgeon will need to use a combination of gathering and sliding maneuvers to adjust the working distance to the knot.  Next are some guidelines to follow in order to ensure optimal suture-strand lengths during knot tying.
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Free
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Fixed
For instrument ties, the fixed suture-strand should be held 3–4 inches (8-10cm)  from the knot and the free strand should be around 1–2 inches (3-5cm) from the knot.
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Length of Suture
When tying knots, it is important to grasp the suture at a comfortable working distance from the knot.  To achieve these optimal working distances, the surgeon will need to use a combination of gathering and sliding maneuvers to adjust the working distance to the knot.  Next are some guidelines to follow in order to ensure optimal suture-strand lengths during knot tying.
When tying knots using the instrument-or hand-tie techniques, surgeons must be able to lengthen or shorten suture strands. Gathering and sliding maneuvers are finger movements used to adjust the length of the suture strands. Both gathering and sliding can be combined to achieve the optimal working distance when tying knots. In this topic, you will learn how to perform these finger maneuvers. In the next topic, you will apply these maneuvers as you begin to practice knot-tying techniques.
For instrument ties, the fixed suture-strand should be held 3–4 inches (8-10cm) from the knot and the free strand should be around 1–2 inches (3-5cm) from the knot.
Instrument Ties
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Hand Ties
For most hand-tie applications, 4–6 inches (10-16cm) of suture strand on both the fixed and free ends should be available to establish a comfortable working distance to the knot.  
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For most hand-tie applications, 4–6 inches (10-16 cm) of suture strand on both the fixed and free ends should be available to establish a comfortable working distance to the knot.  
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Practice Rope
When using the rope to practice instrument ties, you might find it easier to work with the rope if you add a few more inches to your strands.  
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Gathering
Sliding
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Practice Exercise
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