The major drawback of this technique is that it may be challenging to learn. Once mastered, this technique presents a viable option for securing deep sutures, though as with all techniques it does have some limitations.
This approach leaves a sizable quantity of suture material in place along the incised wound edge. Since this material may serve as a barrier to healing, and may also increase the risk of suture spitting, this is a disadvantage. Moreover, since some of the suture material is placed fairly superficially, and extends laterally along the incised wound edge, if suture spitting or suture abscess formation becomes a problem this may be particularly troublesome as it may affect a greater proportion of the wound rather than the single punctate area as is seen with interrupted sutures.
The added time needed to effectively lock each throw also means that one of the greatest advantages of the running approach—that it is faster than interrupted sutures—is minimized, since the differential between the time needed to tie individual sutures and to effectively lock the line of sutures may not be that great.
Like the standard buried dermal suture, this approach provides less wound eversion than other approaches such as the set-back dermal or buried vertical mattress; therefore, a running locking variation of the latter two techniques may be preferred to a running locking dermal approach, since wound eversion may be associated with improved cosmesis over the long term.