The heavy reinforcing suture technique took a much longer time compared to ordinary suturing techniques.
First, the skin's tension had to be distributed using the 2-0 surgical thread. This part of the suturing process needed to be done in segments, and for every segment, you had to pay attention to the exact point of insertion and exit of the needle. And this had to be decided by taking the tension of the skin and the gap between the stitches into consideration. Aside from that, each stitch had to be made between the fascia and the dermis.
In addition, it was also very difficult to align both sides of the torn skin. Injured skin was not always even, and there might even be situations where there was a deficit of skin. This made alignment even more difficult.