This technique may lead to dramatic wound inversion, and therefore should only be used when the goal is recreating a natural crease. Moreover, since wound inversion may be associated with inferior cosmesis over the long term, the benefit of accentuated inversion should be weighed against the possibility that the long-term cosmetic outcome of the suture scar may be less than ideal. The over-inversion of the wound edges caused by the suturing technique relaxes somewhat after suture removal, allowing the wound edges to meet and heal.
This technique does not contribute at all to epidermal-edge apposition, and therefore it should ideally be used after dermal sutures have been placed that have effectively aligned the wound edges to permit improved healing.
As with any transepidermal technique, this approach may result in residual track marks; removing sutures in a timely fashion helps mitigate this risk, and utilizing fast-absorbing gut suture may also be a reasonable option.