"For decades, the world's governments have financed the creation of biological weapons. Airborne viruses that calcify the organs of their victims, developed for war. Yet those same governments are surprised when such weapons are used against them. Modern man is the very model of hypocrisy. You glorify the discovery of medicine, yet hide the fact that the same knowledge is used to create disease!" -Adam
"...And you'd rather create new ways for us to die? That's insane!" -Derek Stiles
"...Human history is one of mistakes, but there are those of us who don't want to repeat them!" -Naomi Kimishima

Triti is the third strain of GUILT encountered in Under the Knife and Second Opinion. Triti is also known as the "Contagious Nightmare."

Triti creates a series of triangular membranes on an organ that petrifies the organ. Each edge of a membrane is held in place by a thorn. When a membrane is excised, Triti will attempt to extend its membrane to cover more of the organ.

Triti was based on a failed cancer treatment by Caduceus Europe which somehow came to Delphi's attention.

Survivors of Triti can contact Post-Triti.


Each corner of the triangular membranes of Triti is held in place by a thorn. These thorns must be pulled directly upward with the forceps, then placed on the tray to remove it. Triti thorns will regenerate after a set period of time, which is related to the amount of Triti membranes are currently covering the organ. Triti thorns may dissolve into a mist that must be drained. If the mist is allowed to move freely, it will create new membranes that will multiply along with the other remaining pieces. If the mist escapes the area of operation, it causes an instant operation failure, or further infects patients.


Figure 1

Triti membranes multiply under two conditions. The first example occurs if the player removes a membrane, and if there are two adjacent thorns and a free side where a membrane can appear from. Figure 1 demonstrates this method of multiplication, where a membrane appeared on a free side with 2 adjacent thorns on it. No membranes appeared anywhere else because either there is no space for a membrane to appear, or the adjacent thorns are not linked by the edge of a membrane.


Figure 2

The only other time Triti can extend its membranes is when a membrane has no other membranes on any of its sides and has at least one thorn on a corner. If this occurs, it will instantly create three membranes, one for each section adjacent to the lone membrane. In Figure 2, after removing the Triti membrane as seen in the left half of the image, there is one lone membrane with a thorn on its vertex. As such, three membranes will be created around the first one, as shown in the right half of the image.

Over the process of the operation, the patient's vitals will decrease according to the number of membranes still on the organ. From time to time, one of the membranes will take on a different coloration, and its presence will cause the patient's vitals to drop faster until it is extracted.

In Under the Knife, dropping a membrane while extracting it will also cause it to reattach at its new position and grow thorns, and thus multiply in this way as well.


Under the KnifeEdit

Note: * refers to patients who are only operated on if the gas escapes the operating field of the previous patient. Only one of these patient needs to be saved to complete the level.
Episode Patient Organ(s)
3-10: Pandora's Box Reuben Pancreas
5-3: Shifting GUILT Hugh Vogler Pancreas
Shane Carter* Pancreas
6-4: Third Sin Unnamed boy (Third Sinner) Stomach
X-3: Triti Unnamed man Pancreas

Second OpinionEdit

Note: * refers to patients who are only operated on if the gas escapes the operating field of the previous patient. Only one of these patient needs to be saved to complete the level.
Episode Patient Organ(s)
3-10: Pandora's Box Reuben Pancreas
5-3: Shifting GUILT Hugh Vogler Pancreas
Shane Carter* Pancreas
George Wylie* Pancreas
6-7: Fallen Heroes Alex Yang Stomach
X-3: Triti Unnamed man Pancreas


Triti deals damage every few seconds based on how many membranes are currently covering the organs. As previously noted, it has no actual attacks unlike Kyriaki, but it will continue to harm the host until it is cured.

Attack Information
Thorn Dissolution Triti creates a mist that will spread to other areas in order to create more sections of the membrane, or to fail the operation.
Blue Membrane One section of Triti will turn blue. This section will deal damage separately from the intermittent pulse of damage from the other pieces, and the damage it will deal is more severe.


  • The Time Slow Healing Touch is able to allow the player to remove all the Triti thorns and membranes before Triti has the chance to react. Note that doing this will give a severe penalty to the rank, especially in Second Opinion where the "No Healing Touch" special bonus is worth a whopping 1000 points.
  • Players may find it difficult to achieve XS rank in Second Opinion's X-3. This is due to the lack of chain or score if the player works too fast. Once the player works down to 2 membranes left, they can simply continuously remove the thorns without touching the membranes out of hope that the chain gets high enough or the thorn dissolves to give a gas cloud (which gives more points than simply excising the thorn). Be mindful of vitals and the time limit, though.
  • The "brute force" method to extract Triti without using the Healing Touch exploits the fact that Triti cannot expand outside of the organ boundaries. This method often results in Triti covering most of the organ within the first few extractions, then slowly working on the outermost lines of membranes until it has been fully extracted. The need to manage the remaining Triti thorns is reduced, but a player loses out on the "membrane multiplied less than X times" bonus, if applicable.


  • Japanese versions of Trauma Center have mixed up Triti with Tetarti, resulting in them having the other's name in that version.
  • Triti is the only GUILT that can be treated in less than 20 seconds, thanks to the Healing Touch. That said, some consider it to be the most annoying GUILT, due to its ability to regenerate in bigger numbers if given the chance.
  • Whenever Triti multiplies, a "scream" is heard. Supposedly this sound is the organ screaming from being petrified.
  • Triti is based off diffuse systemic scleroderma, which is a form scleroderma that causes the hardening of skin often associated with CREST syndrome. DSS not only hardens the skin, but also one or more of any internal organ from the heart, the lungs, the esophagus or the kidneys. There is no cure or treatment for scleroderma, complications and organ failure must be treated when they happen and it becomes fatal within five to fifteen years.
    vde Diseases and Conditions
Common Conditions AneurysmAppendicitisBurnCardiac ArrestCholelithiasisForeign ObjectHemorrhageInflammationLacerationTumor
GUILT KyriakiDefteraTritiTetarti (Diverticulum) • PemptiParaskeviSavatoBliss
Stigma CheirSomaOpsOnyxBrachionCardia
Post-GUILT Syndrome Post-KyriakiPost-TritiPost-PemptiPost-Savato
Neo-GUILT NousBythosSigeAletheia
Other Rosalia Virus (Twisted Rosalia) • Costigar DiseaseVaimahse Fever
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