The Efficient Knot: Redefining Simplicity in High-Tension Wound Closure

Closing wounds under high tension often requires complex maneuvers or significant non-dominant hand involvement. We present a novel, single-handed suturing technique that simplifies this process. Following standard loop formation, the needle holder passes under the long suture end, over the short end, and under again to grasp the free thread, creating a self-locking configuration. This technique limits the non-dominant hand to simply holding the suture end while maintaining precise tissue approximation. It works with both monofilament and braided sutures and is applicable to skin closure, fascial repair, and anatomically challenging locations. The straightforward execution makes it accessible to surgeons across all skill levels.