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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.
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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.
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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.