A number of papers have investigated what type of knot could be considered to be best, even looking at the addition of surgical glue to aid security. Secure knots that will not slip or fail, are essential for safe surgical and interventional practice, ensuring haemostasis, the integrity of anastomoses, secure and appropriate apposition of wounds, and security of interventional devices. Knot tying is an essential basic practical skill required by all surgeons, veterinary surgeons and any clinician engaged in patient procedures, in all medical as well as surgical specialties. 9 Department of Statistical Analysis, University of Plymouth, Plymouth, Devon, UK.8 Department of Otorhinolaryngology, University Hospital of Larissa, Mezourlo, Greece.7 Department of General Surgery, University Hospital of Larissa, Mezourlo, Greece.6 Surgical clinic B, General Hospital Georgios Gennimatas, Athens, Greece.5 Department of Surgery, IASO Hospital Thessalias, Larissa, Greece.4 Department of Plastic Surgery, Hopital Universitaire Henri Mondor, Paris, France.3 Surgical Directorate, University of Plymouth Hospitals NHS Trust, Derriford Hospital, PlymouthPL6, Greece.2 Royal College of Surgeons of England, London, London, UK.1 Clinical lead BSS course RCS England, Consultant Surgeon (retired), University ofPlymouth Hospitals NHS Trust, Plymouth, UK.
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