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adhesive adipose tissue applying tension approximated bacterial contamination biologic interaction biomechanical properties clinical closure technique collagen configuration contaminated wounds Dacron delayed primary closure dermal sutures dermis development of infection Double-Double dynamic skin tensions Edlich epidermis epithelium fibers FIGURE granny knot grasped hand is passed incidence of infection incision infection rate lacerations Langer's lines least reactive suture left hand left index finger left thumb magnitude monofilament needle holder nylon patient percutaneous sutures polyester polyglycolic acid polypropylene rectangular shaped loop resistance to infection result right hand second throw skin edges skin sutures skin wound soft tissue square knot staple staple remover stapler static skin tensions surgeon's hands surgeon's knot square surgery surgical surgical tape sutural closure suture end held suture held suture loop suture material suture removal sutured wounds tape closure tape skin closures tensile strength thumb and index tied suture tips traumatic wound closure wound edges wound infection wounds subjected