(a) Surgeon's knot, step 1: the suture needle is wound around the needle holder twice in the direction of the wound. (b) Surgeon's knot, step 2: the free end of the suture is grabbed with the needle holder and the knot is tightened to the tissue. (c) Surgeon's knot, step 3: the suture needle is wound around the needle holder once away from the wound, and then the free end of the suture is grasped and tightened, completing the knot.