The Peruvian fisherman's knot: a new, simple, and versatile self-locking sliding knot.

Abstract

In many plastic surgery operations that are undertaken through relatively small incisions resulting in deep-seated operating fields, sliding knots with a self-locking property are preferred by plastic surgeons for 3 reasons: simplicity, reliability, and versatility. We describe a new and versatile sliding knot that can be easily sledded and locked. The technique of knot tying is described in detail as a stepwise approach with photographs. The main advantages of the Peruvian fisherman's knot are compared with other methods and summarized. In addition to its adjustment-related properties, knot security has been adequate with this knot as evidenced by its clinical performance and the authors' experiences to date. The Peruvian fisherman's knot is especially useful while working in deep seated operating fields through a small incision. Tension created during knot tying is adjustable, which makes it an ideal choice for various lifting procedures in plastic surgery.