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Disclaimer: NOT intended for medical instruction or guidance. This video is only a demonstration of a surgical simulation. Simulation of frail tissue closure demonstrated by a laceration in a surgical glove. The glove is stuffed with grains to add tension on the material for increased frailty. Simple running technique is changed to a mattress technique to account for sheering of frail tissue. Final closure is secure with no further sheering of tissue or loss of grains. Particular attention is given to the finger and wrist motion of the fine forceps to practice proper motion of the Castroviejo forceps. Hand positioning (with pinky outstretched) as taught in the Ethicon coronary anastomosis simulation course for additional stability. 0:00 Anchoring Stitch Beyond Incision 1:04 Forehand Running Suture (5-0 Prolene) 3:35 Mattress Technique 3:45 Removing Excess Grains to Relieve Tension 6:35 Knot Tying 7:05 Final Product