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Basic Surgical Skills Log Book Student Name: Cohort Year:

Skill Practiced Date Mastered Date Surgeon Name & Sign Knot tying Instrument tie Two handed One handed, non-dominant One handed, dominant Slip knot technique One handed tying at depth Pedicle ligation Pedicle ligation at depth Aberdeen knot Suturing Skin – simple interrupted Skin – vertical mattress Skin – horizontal mattress Skin – subcuticular continuous Skin – subcuticular interrupted Skin – interlocking stitch Figure of 8 stitch Drain stitch Intestine – gel model Vessel – end-to-end Vessel – end-to-side Vessel – side-to-side

*Students need to practice each technique in order on the list. The Practiced column can be completed in the skills lab. To complete the Mastered column the skill needs to be performed in front of, and signed by, a Surgical Consultant/Registrar.

Student Name: Cohort Year: Practiced DateKnot tying Instrument tie: Mastered DateKnot tying Instrument tie: Surgeon Name SignKnot tying Instrument tie: Practiced DateTwo handed: Mastered DateTwo handed: Surgeon Name SignTwo handed: Practiced DateOne handed nondominant: Mastered DateOne handed nondominant: Surgeon Name SignOne handed nondominant: Practiced DateOne handed dominant: Mastered DateOne handed dominant: Surgeon Name SignOne handed dominant: Practiced DateSlip knot technique: Mastered DateSlip knot technique: Surgeon Name SignSlip knot technique: Practiced DateOne handed tying at depth: Mastered DateOne handed tying at depth: Surgeon Name SignOne handed tying at depth: Practiced DatePedicle ligation: Mastered DatePedicle ligation: Surgeon Name SignPedicle ligation: Practiced DatePedicle ligation at depth: Mastered DatePedicle ligation at depth: Surgeon Name SignPedicle ligation at depth: Practiced DateAberdeen knot: Mastered DateAberdeen knot: Surgeon Name SignAberdeen knot: Practiced DateSuturing Skin simp l e interrupted: Mastered DateSuturing Skin simp l e interrupted: Surgeon Name SignSuturing Skin simp l e interrupted: Practiced DateSkin vertical mattress: Mastered DateSkin vertical mattress: Surgeon Name SignSkin vertical mattress: Practiced DateSkin horizontal mattress: Mastered DateSkin horizontal mattress: Surgeon Name SignSkin horizontal mattress: Practiced DateSkin subcuticular continuous: Mastered DateSkin subcuticular continuous: Surgeon Name SignSkin subcuticular continuous: Practiced DateSkin subcuticular interrupted: Mastered DateSkin subcuticular interrupted: Surgeon Name SignSkin subcuticular interrupted: Practiced DateSkin interlocking stitch: Mastered DateSkin interlocking stitch: Surgeon Name SignSkin interlocking stitch: Practiced DateFigure of 8 stitch: Mastered DateFigure of 8 stitch: Surgeon Name SignFigure of 8 stitch: Practiced DateDrain stitch: Mastered DateDrain stitch: Surgeon Name SignDrain stitch: Practiced DateIntestine gel model: Mastered DateIntestine gel model: Surgeon Name SignIntestine gel model: Practiced DateVessel endtoend: Mastered DateVessel endtoend: Surgeon Name SignVessel endtoend: Practiced DateVessel endtoside: Mastered DateVessel endtoside: Surgeon Name SignVessel endtoside: Practiced DateVessel sidetoside: Mastered DateVessel sidetoside: Surgeon Name SignVessel sidetoside: