A method for approximating a wound using a uni-directional, barbed wound closure device having a needle and a stop element. The method includes taking a first pass by entering intact tissue at a location in proximity to the first apex and exiting in intact tissue at a location away from and above said first apex, pulling the wound closure device until the stop element is seated above the tissue plane, moving back toward the first apex and taking at least a second pass in a direction substantially perpendicular to the first pass at a location above or adjacent to the first apex, moving in a direction toward the second apex, approximating the wound using a continuous suturing pattern, moving toward the first apex, taking at least two passes across the wound, and cutting off a free end of the wound closure device in proximity to a surface of the tissue.