Direct comparison
Monofilament vs Multifilament Suture: Evidence
Monofilament vs multifilament suture: handling, capillarity, FDA treatment and what cesarean and laparotomy closure trials found, with Vicryl and Monocryl.
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How do Monofilament, Multifilament (braided) compare side by side?
The table below compares Monofilament, Multifilament (braided) across 11 procurement-relevant dimensions, from definition through source.
Side-by-side comparison
| Dimension | Monofilament | Multifilament (braided) |
|---|---|---|
| Definition | A single filament (one strand). | Several filaments, braided, forming one strand. |
| Tissue passage and drag | Structure facilitates passage through tissue; low tissue drag (manufacturer glossary). | Braided surface can cause a saw effect on tissue; the manufacturer coats its braided sutures to reduce this. |
| Capillarity and infection spread | Prevents capillarity; low propensity to spread infection (manufacturer glossary). | Spaces between the fibres can facilitate the spread of pathogens along the fibre and can harbour bacteria (manufacturer glossary). |
| Handling and knots | Described as less manageable than braided. | Described as more manageable; the manufacturer rates it better on flexibility and knot fixation. |
| Thread memory | Memory is a minus in the manufacturer table; threads with memory tend to form knots spontaneously, and nylon is the example given. | Not rated as a weakness in the manufacturer table. |
| Examples covered on CASRAI | Monocryl (poliglecaprone 25, absorbable), Ethilon (nylon, nonabsorbable), Prolene (polypropylene, nonabsorbable). | Vicryl (polyglactin 910, absorbable), Nurolon (nylon 6,6, nonabsorbable), Ethibond (polyester, nonabsorbable). |
| How FDA treats the form | Filament form is a variation within one device type, not a separate class: 21 CFR 878.4493 says absorbable poly(glycolide/l-lactide) suture may be monofilament or multifilament (braided), uncoated or coated. Class II (special controls). | Same regulation and class as the monofilament form; braided is a permitted form, not a separate FDA category. |
| Evidence: cesarean subcuticular skin closure | Meta-analysis of 4 studies (Sobodu et al., 2024): monofilament (poliglecaprone 25 or polypropylene) vs polyglactin 910 gave lower surgical site infection, RR 0.71 (95% CI 0.52-0.98, I2 0%). | Comparator in that analysis was polyglactin 910; no difference in hematoma, seroma or dehiscence between the two groups. |
| Evidence: laparotomy fascial closure | Cochrane review (Patel et al., 2017): monofilament vs multifilament reduced incisional hernia risk, RR 0.76 (95% CI 0.59-0.98), moderate-quality evidence. | None of the interventions compared reduced the risk of wound infection, including absorbable vs non-absorbable. |
| When each fits (per the manufacturer glossary) | Chosen for strength, low tissue drag and less capillarity. | Chosen for handling; the glossary notes braided sutures are widely used in practice. Material choice remains a clinician decision. |
| Source | B. Braun Suture Glossary (read 2026-11-01); 21 CFR 878.4493 (Cornell LII, read 2026-11-01); Sobodu O et al., J Obstet Gynaecol Can 2024;46(1):102191, PMID 37595945; Patel SV et al., Cochrane Database Syst Rev 2017;11:CD005661, PMID 29099149. | Same sources. |
Common questions
Common questions about Monofilament vs Multifilament (braided)
What is the difference between a monofilament and a multifilament suture?
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A monofilament suture is one strand, while a multifilament (braided) suture is several fibres worked together. The manufacturer glossary links the single strand to low tissue drag and less capillarity, and the braided form to easier handling.
Are monofilament sutures absorbable or nonabsorbable?
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Either. Filament form and absorbability are separate attributes. Monocryl is an absorbable monofilament; Ethilon and Prolene are nonabsorbable monofilaments. Vicryl is absorbable and braided; Nurolon and Ethibond are nonabsorbable and braided.
Does FDA classify monofilament and braided sutures separately?
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In the regulation read for this page, 21 CFR 878.4493 for absorbable poly(glycolide/l-lactide) suture, the strand may be monofilament or multifilament (braided), so form is a variation within one device type (Class II).
Do trials show monofilament sutures lower infection risk?
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It depends on the setting. A 2024 meta-analysis of cesarean subcuticular skin closure found fewer surgical site infections with monofilament (RR 0.71). A 2017 Cochrane review of laparotomy closure found no wound-infection reduction from any intervention compared, but fewer incisional hernias with monofilament (RR 0.76).
Why do braided sutures carry a coating?
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The manufacturer glossary says the braided surface can cause a saw effect on tissue and that all of its braided sutures are coated to reduce it.
What about nylon vs Prolene, or PGA vs Vicryl?
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Those compare materials rather than filament form; see the related CASRAI comparisons and guides below.
