The greatest drawbacks of this approach are time, suture material use, and the risk of oversewing and subsequent tissue necrosis, particularly with multiple closely spaced anchoring sutures. Since each suture crossing the incision requires two anchoring sutures, this technique may take significantly longer to execute than other approaches. Moreover, the excess suture material that needs to be used to incorporate this approach means that on longer closures additional packages of suture material may be needed.
Finally, placing multiple anchoring sutures parallel to the incision line may lead to impaired vascularization and an increased risk of wound-edge necrosis, since a significant proportion of the skin surrounding the wound is encompassed by suture material that has the potential to constrict the underlying vessels.
With any suturing technique, knowledge of the relevant anatomy is critical. When placing these sutures it is important to recall that the structures deep to the epidermis may be compromised by the passage of the needle and suture material.
This technique may elicit an increased risk of track marks, necrosis, and other complications when compared with techniques that do not entail suture material traversing the scar line, such as buried or subcuticular approaches. Therefore, sutures should be removed as early as possible to minimize these complications, and consideration should be given to adopting other closure techniques in the event that sutures will not be able to be removed in a timely fashion. Some studies have also demonstrated an increased rate of dehiscence when utilizing interrupted sutures alone without underlying dermal tension-relieving sutures, highlighting that this technique should be used either for wounds under minimal tension or in concert with deeper tension-relieving sutures.