Abdominal wound closure with a single polydiaxone loop can result in an unsightly and bulky knot which is palpable in the subcutaneous tissue, especially in thin patients. We present a simple technique to prevent this when tying a finishing knot. First, pass the needle holder through the loop and hold one strand of the suture. Cut that thread close to the needle and bring back through the loop again. The knot is tied over the loop thus securing the closure. This results in a small knot which is less likely to cause patient discomfort.
Figure 1.
Passing the needle holder through the loop and holding one strand of the suture.