 So let's say for the time being, let's say Ryan, you'll be my assistant, okay? So this we classically do to give you the example as I was telling you, we do it for closing the uterus. As you not be able to hear the baby, the uterine margins will bleed like anything. It means it really did, really, really bleed. So if you don't take locking, the reading is not stuck. So let's show you how this locking sutures work. Let me make a fresh incision. Do we have a blade here? We do, yeah. Okay, so let me make this incision. In the process you can see how to make an incision also. The way to make an incision is always hold the knife like a pen. Use the index finger to control the tip. At an angle of 45 degrees, go straight in and give a little traction with your other hand and come straight down. Imagine I'm opening the linear. I made the incision into linear. First, you may not go through the full thickness of the skin, you can deepen it. Here, I've just done it with my hand, but so this is the skin incision we have made. Okay. So I'm going to show you locking sutures. Do you want to take one? Yes, this angle is not the ideal for a skin suture. We need a bigger needle. The first step is the pretty much the same, so we just go the way we were going earlier. In order to prevent wastage of the material, what we do is we keep it as close as possible. Always bring the knot to one side. Never keep the knot on the suture line because it will produce a painful scar. Okay, so normally we'll have a needle holder holding this, but here we don't have it, so we'll just keep it like this. Now you have to exert traction and keep maintaining the traction. I'll tell you what to do. You will have a crucial role to play in this locking business. Are you still using the archery forceps instead? We will use an archery forcep to hold this end and keep it aside. You don't mean how? Yeah, what we do is, after you have done this, we just clamp it with an archery forcep. Imagine there's an archery forcep, so that it's out of the way. The assistant maintains traction. Not too much, just a little bit, so that now I'll take the next bite, and I'll tell you when to, you'll see the difference between a continuous and a continuous locking. Okay. Imagine there's just a bleeding profusely, okay? Once I've taken it out, what I'll do is I'll just pass it around through the loop. Release it. There. This thing is now maintained the traction, vertical traction. You'll find that it'll stop the bleeding very quickly. Next bite. Keep the loop there. I'm going to pass it through. Okay. Release there. Lovely. See, now what I'm doing is with each knot, each loop, I'm locking it. Next, this and this here. Again, I'm going to pass it through the loop here. See? So now there's a vertical strand coming between the loops. This is called locking stitches. But for this, the assistant has to maintain constant traction. You have to maintain traction like this. With your left hand. Yes. Then we take the other side. Pass it in. This is not done on the skin. This is done on the uterus or on the stomach when we're closing the stomach after a gastrotomy. Because these are the edges which keep bleeding even after we have put again and pass it through. So you see how important it is to keep maintaining the traction? Yeah. Because if you release the traction, the whole thing will become loose. Okay. Just pull it again. So the traction has to be quite firm and you should not allow it to become loose at any stage. Always go through the loop and tighten it. Yes. And this will be our last and we'll tie up the knot the usual way which we have learned and I'll show it to you again. Now we don't loop it. We just maintain this thing here and we catch hold of it and we tie it off. So why don't we use this on superficial? This is because if you do it on the skin, it makes a very ugly scar. Is it not? And your skin does not require this type of locking. It requires only for smooth muscle which bleeds. That's why I said stomach and uterus. We have closed it. So the difference between a continuous suture that we have seen and the other sutures is that here there's always a band running. If you notice very carefully, there's a band connecting each. Yeah. That is the purpose of locking. So this vertical band is the one which applies constriction and prevents bleeding from the edges. So this is done when we are seeing too much of bleeding from the margins and that is usually seen in smooth muscles like the uterus, stomach and such thick muscles. So this is a continuous modification of the continuous suture. It's called continuous locking. The assistant plays a major role. He holds it up in a loop and you pass it through the loop and you tighten it. So you keep doing it with each knot. You wouldn't use a cordary pencil for this whole thing. See the uterus muscle is so thick. Yeah.