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A surgeon's knot is a type of reef knot where the first knot has two turns. It is an elaborated form of the square knot, created by tying two overhand knots in opposite directions, but with an extra twist after the first overhand knot is tied. This additional twist helps hold the rope parts in place with friction until the second overhand knot is secured. The surgeon's knot is also known as a surgical knot. This knot was historically used in surgery for tying ligatures around arteries.123

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