Monocryl Suture and its Absorbable Suture Characteristics

Absorbable suture materials are those that are broken down. The special characteristic of absorbable sutures is that they lose most of their tensile strength within sixty days after placement. These materials are broken down by hydrolysis but not by enzymes. Water penetrates the suture filaments and causes breakdown of the polymer chain. As a result, synthetic absorbable tends to evoke less tissue reaction than plain or chromic gut. They are used primarily as buried sutures to close the dermis and subcutaneous tissue and reduce wound tension. Today there are many synthetic absorbable suture materials made from polymers. One example of this is Monocryl suture which was manufactured by a company called Ethicon and that was also a part of the Johnson and Johnson Company. It was first introduced in the year 1993.

It is generally used for soft-tissue approximation and ligation. Monocryl sutures are composed of a compound known as poliglecaprone 25. This is a copolymer of glycolide and epsilon-caprolactone. A polymer means that it has recurring large molecules made from smaller molecules of the same kind. It is a monofilament material, but is very pliable in spite of this. It also has excellent pliability and provides easy handling and good knot security.  Monocryl suture comes dyed with gentian violet which makes it easier to see in surgery. It also comes undyed which is the preferred option for plastic surgery use since it’s not visibly seen in the healing process of the scars.

There are many advantages of using Monocryl suture. The dyed form of Monocryl retains sixty to seventy percent of its strength in the first week and thirty to forty percent in the second week, while the colored form of Monocryl retains fifty to sixty percent of its strength in the first week and twenty to thirty percent in the second week. These statistics show that it has a very high rate of absorption. It is essentially completely hydrolyzed by ninety to one hundred and twenty days. Monocryl has low tissue reactivity, maintains high tensile strength, and has a half-life of seven to fourteen days. When taken out of the package, it has a high degree of memory, or coil. One other benefit of monocryl sutures is that it is slippery, making it easier to pass than a braided suture. It has a consistency close to the nylon suture material. It is rarely used for percutaneous skin closure, and is not used in areas of especially high tension. One example of this is fascia.

Poliglecaprone is most useful as a buried suture in wounds in which prolonged dermal support is not essential. Similar to other monofilament sutures, poliglecaprone has minimal tissue drag and reactivity. The cost of poliglecaprone is comparable to that of polydioxanone. An antibacterial form of poliglecaprone is now available. The antibacterial agent is triclosan, which has been shown to inhibit colonization of the suture by methicillin-sensitive and methicillin-resistant S aureus and S epidermidis, Escherichia coli, and Klebsiella pneumoniae, even after direct in vivo challenge with bacteria. The tensile strength and absorption profile are not affected, however, and are similar to that of untreated poliglecaprone.