If the suture strands are short, a two-handed tie is more easily performed than a one-handed tie. A one-handed tie generally requires longer suture strands to manipulate the strand to place the throws. 

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It is often the surgeon’s preference whether a one or two hand tie is used. There are several important factors to consider when selecting a manual knot-tying technique. Here are some guidelines to consider when deciding whether to use a one-handed or two-handed tie.

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Both one- and two-handed techniques can be used to push throws down into deep cavities to form a knot. Bear in mind that it is more difficult to form square knots when throws are pushed down, particularly with one-handed ties. Therefore, many surgeons favor the two-handed technique as demonstrated in the deep tie video.

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