An instrument and methods of making and use for sealing a small, e.g., percutaneous, incisions or punctures. The instrument in the form of a tubular member having a plug therein. The tubular member includes a proximally located piston and a distally located portion having an open free end for introduction into the incision or puncture. The plug comprises a cord and a thin filament, with the cord being formed of a resorbable material and being folded in two to form an apex portion and a pair of wing portions extending therefrom. The filament is secured to the apex portion. The plug is located within the tubular member so that the apex portion is disposed adjacent the free end and with the wing portions and the filament extending toward the proximally located portion. The plug is then expelled partially from the tubular member so that the apex portion extends through the incision or puncture. The filament is then drawn proximally direction to pull the apex portion into engagement with the free end of the tubular member to expand the apex portion to form a head having a tissue engagement surface. The plug is then drawn back through the incision or puncture so that the tissue engagement surface intimately engages the tissue contiguous with the incision or puncture.