Abstract
Tying sutures under tension is a common challenge in surgery. Various solutions to this problem include pulley sutures, buried mattress sutures, hand tension ties, towel clamps, and surgical assistant to physically relieve tension on the closure. Disadvantages of these techniques include increased suture waste and additional time involved in suture placement.1 Penetrating towel clamps cause tissue trauma and require an extra instrument on the tray. For various reasons, support staff are not always readily available.
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