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A Heegaard splitting of a closed oriented three-manifold is a decomposition $Y=H_0{\cup }_{\Sigma }{H}_1$ into two handlebodies, with their common boundary the Heegaard surface $\Sigma$. With boundary present, the corresponding pieces are compression bodies, whose negative boundaries account for $\partial Y$.

For the given triangulation, take the barycentric subdivision. A regular neighbourhood $H_0$ of the original one-skeleton is a handlebody: thicken vertices to balls and edges to one-handles, then contract a spanning tree. The complementary region is a regular neighbourhood $H_1$ of the dual one-skeleton, whose vertices are tetrahedron centres and whose edges cross triangular faces. It too is a handlebody. Both graphs are connected, and their common boundary supplies the Heegaard splitting. If the original triangulation has $v$ vertices and $e$ edges, its Heegaard surface has genus $e-v+1$; the dual count gives the same number by $v-e+f-t=0$.

Choose an oriented meridian of a knot $\mu$ and the Seifert longitude $\lambda$ supplied by a Seifert surface for the null-homologous knot. For relatively prime integers $p,q$, rational Dehn surgery removes the interior of a tubular neighborhood and attaches a solid torus with its meridian of a solid torus on the unoriented slope $p\mu +q\lambda$. The choices $(p,q)$ and $(-p,-q)$ describe the same slope; $q=0$ is the original meridional filling. The boundary gluing reverses boundary orientation so that the oriented three-manifold extends across the filling.

For integral coefficients $n_i$, attach two-handles to $B^4$ along the components of the framed link, with their indicated Seifert framing shifts. The boundary operation removes $S^1\times D^2$ and inserts $D^2\times S^1$, with meridian $n_i{\mu }_i+{\lambda }_i$. Thus the compact oriented surgery trace satisfiesFor a finite rational coefficient, use a negative continued fractionReplace that component by an integrally framed chain of successive meridians with coefficients $a_0,\dots ,a_k$. Repeated slam-dunk moves give back $p/q$. Perform this replacement for every rationally framed component, leaving meridional fillings out. The resulting integral framed link has the same filled boundary, so its surgery trace proves that every such rational filling bounds a compact oriented four-manifold.