A flexible medical closure screen device for a separation of first and
second tissue portions is provided, which includes a mesh screen
comprising tubular vertical risers, vertical strands with barbed
filaments, and horizontal spacers connecting the risers and strands in a
grid-like configuration. An optional perimeter member partly surrounds
the screen and can comprise a perimeter tube fluidically coupled with the
vertical risers to form a tubing assembly. Various input/output devices
can optionally be connected to the perimeter tube ends for irrigating
and/or draining the separation according to methodologies of the present
invention. Separation closure, irrigation and drainage methodologies are
disclosed utilizing various combinations of closure screens, tubing,
sutures, fluid transfer elements and gradient force sources. The use of
mechanical forces associated with barbed strands for repositionably
securing separated tissues together is disclosed. The use of same for
eliminating or reducing the formation of subcutaneous voids or pockets,
which can potentially form hematoma and seroma effects, is also
disclosed. Alternative embodiments of the invention have circumferential
configurations for approximating and closing separated tissue portions
such as tendons, nerves and blood vessels. Tissue closure methods include
the steps of circumferentially applying a screen to separated tissue
portions and penetrating the tissue portions with prongs.