This technique can be very useful in correcting slight imperfections in the equality of the depth of wound edges. Ideally, however, this technique should be employed infrequently, since as long as the deeper sutures are placed accurately and appropriately, it should only rarely be necessary.
Therefore, caution should be exercised to avoid utilizing this technique as a crutch; as long as the surgeon appreciates that the use of this approach should be the exception, rather than the rule, it is acceptable, but it should not be utilized in lieu of attention to detail and precise placement of deeper sutures.
Some anatomic locations, however, may intrinsically present the surgeon with areas of differential dermal thickness, in which case unless the dermal sutures were placed differentially, depth-correcting simple interrupted sutures may be needed. This includes areas such as the nasal sidewall, the cheek-eyelid junction, and nasofacial sulcus, as well as other skin fold areas.
Finally, caution should be exercised to avoid over-sewing areas with the goal of correcting slight imbalances in epidermal depth. While one or two depth-correcting sutures may be necessary, moderation is key as each suture introduces additional foreign-body material and has the potential to induce an inflammatory response.