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monocryl 2-0 suture, is their any evidence for patient sepsis due to using this suture material

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Monocryl poliglecaprone suture infection sepsis

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Monocryl 2-0 suture sepsis infection evidence clinical

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poliglecaprone suture surgical site infection

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absorbable monofilament suture wound infection sepsis

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PMID: 37595945

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PMID: 38109995

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PMID: 34141950

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PMID: 28796687

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Monocryl 2-0 (Poliglecaprone 25) and Patient Sepsis/Infection - Evidence Summary

What is Monocryl?

Monocryl (poliglecaprone 25) is an absorbable synthetic monofilament suture. It is hydrolysed by the body over 91-119 days and loses tensile strength within 1-2 weeks postoperatively. Its key property relevant to infection is its monofilament structure - a single smooth strand leaves no interstices for bacteria to lodge in, unlike braided/multifilament sutures (e.g. Vicryl/polyglactin 910) which can harbour bacteria between their fibres.
  • Roberts and Hedges' Clinical Procedures in Emergency Medicine, Table 35.1

Is There Evidence Linking Monocryl to Sepsis?

Short answer: No direct evidence exists linking Monocryl 2-0 specifically to patient sepsis. In fact, the evidence consistently points in the opposite direction - Monocryl is associated with fewer wound infections and complications compared to multifilament absorbable alternatives.

Evidence from PubMed

1. Systematic Review + Meta-Analysis (Highest Evidence - Tier 1)

Sobodu et al., 2024 - J Obstet Gynaecol Can [PMID: 37595945]
A systematic review and meta-analysis of 1,541 studies (4 RCTs/cohort studies included) comparing monofilament sutures (including poliglecaprone 25/Monocryl) vs multifilament sutures (polyglactin 910/Vicryl) for subcuticular skin closure:
Monofilament sutures were associated with a reduced risk of surgical site infection (SSI) compared to multifilament sutures: RR = 0.71 (95% CI 0.52-0.98, I² = 0%).
No difference in hematoma, seroma, or dehiscence was found.

2. RCT - Buresch et al., 2017 - Obstetrics & Gynecology [PMID: 28796687]

  • 520 women randomised to poliglecaprone 25 vs polyglactin 910 after cesarean delivery.
  • Poliglecaprone 25 (Monocryl) was associated with significantly fewer overall wound complications: 8.8% vs 14.4% (RR 0.61, 95% CI 0.37-0.99; P=.04).

3. RCT - Sharma et al., 2024 - Am J Obstet Gynecol MFM [PMID: 38109995]

  • 200 women randomised: poliglecaprone-25 (3-0) vs polyglactin-910 (4-0) for cesarean skin closure.
  • SSI rates were equivalent between groups (8 vs 7 events; RR 1.08, 95% CI 0.64-1.83; P=1.000).
  • Poliglecaprone-25 had significantly less postoperative pain at day 3 and 6 weeks.
  • No cases of sepsis reported in either group.

4. Histological + Microbiological Study - Villagomez et al., 2021 - Vet Anim Sci [PMID: 34141950]

  • In a mouse model, bacterial colony counts (CFU) were no different between Monocryl sutures and cyanoacrylate tissue adhesive 48 hours after incision closure.
  • No excess bacterial proliferation attributable to the Monocryl suture material itself.

Why Monocryl is NOT a Sepsis Risk - Mechanism

PropertyMonocryl (Poliglecaprone 25)Implication
StructureMonofilamentNo bacterial harbouring between fibres
DegradationHydrolysis (not enzymatic)Minimal inflammatory tissue response
BiocompatibilityHighLow foreign body reaction
Absorption timeline91-119 daysGone before chronic infection can establish
Braided alternative (Vicryl)MultifilamentHigher infection potential due to capillary spaces
The NICE evidence review on surgical site infections also notes that braided sutures can trap bacteria, increasing infection potential - a risk that monofilament materials like Monocryl do not share.

Monocryl "Plus" - Antibacterial Variant

J&J MedTech produces MONOCRYL Plus, which is impregnated with triclosan - an antibacterial agent. This variant provides in vitro activity against S. aureus, S. epidermidis, MRSA, MRSE, and E. coli for up to 11 days. The existence of this antibacterial formulation underlines that the concern with sutures is infection prevention, not suture-related sepsis induction.

Clinical Bottom Line

  1. No published evidence shows Monocryl 2-0 causes or is associated with patient sepsis. A PubMed search across the last 10 years returns zero results linking Monocryl specifically to sepsis outcomes.
  2. The available high-quality evidence (systematic review + multiple RCTs) shows Monocryl reduces or is equivalent to comparator sutures for SSI rates - it does not increase them.
  3. Any sepsis occurring in the context of a surgical wound is overwhelmingly driven by patient factors (immunosuppression, diabetes, obesity, wound contamination class, operative field conditions) rather than by the suture material itself - particularly a synthetic monofilament like Monocryl.
  4. If sepsis concern is operative-setting-specific (e.g. contaminated or infected field), suture choice is a minor variable. Wound irrigation, debridement, operative technique, and antibiotic prophylaxis are far more clinically significant.
If you have a specific clinical scenario in mind (e.g. a patient who developed sepsis after a procedure using Monocryl, or a particular anatomical site), I can look into that context more specifically.
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