Reliable vascular pedicle ligation is a required skill of any veterinarian performing surgery. Ineffective vascular ligation can be a life-threatening surgical error, leading to severe blood loss, repeated exploratory surgery, and death. Hemorrhage is the most common cause of death after ovariohysterectomy. Significant hemorrhage is a notable risk when ligating thick ovarian pedicles with high fat content; and the initial throw of the ligature is of critical importance. If the initial square throw is not tight or does not retain its initial tension, the ligated tissue and vessels will bleed despite successive tight square throws. This can occur due to elastic recoil of the tissue, or from uneven tension applied to the suture strands during subsequent throws. Friction knots are recommended to maintain extrinsic tension on the ligated tissues between the first and subsequent throws. The associated video demonstrates the proper technique to form the following 3 friction knots, along with the alternative Aberdeen knot used in subcutaneous and intradermal closures.
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