Needle-free gauze knot-tying training using human hair: A low-cost, accessible method for basic microsurgical skill...

Knot-tying practice on surgical gauze using 10-0 nylon suture is widely used as an introductory exercise in microsurgical training. The conventional approach, however, entails concerns regarding cost, supply, needle loss, and needlestick injury. To describe a needle-free gauze knot-tying training method using human hair, and to discuss its educational implications and limitations.

Using forceps alone, a single strand of human hair was passed manually through the mesh of commercially available surgical gauze, and loop formation and knot-tying were performed. The procedure and its position relative to previously reported gauze-based training methods were examined.

Because human hair is slightly thicker and more elastic than 10-0 nylon suture, it could be passed through the gauze mesh without a needle. The same elasticity introduced characteristic difficulties in loop maintenance, knot advancement, and knot stabilization. These difficulties were considered relevant to the acquisition of tension control, balanced tightening, and avoidance of excessive force.

Needle-free gauze knot-tying training using human hair preserves the framework of established gauze-based training while removing barriers related to cost, supply, and needle handling. The method is best positioned as a preparatory, bridge-type exercise preceding more formal microsurgical practice.