Related Experiment Video
Updated: Mar 29, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Monocryl® vs. Monocryl Plus® in Pediatric Reconstructive Urological Surgery: Outcomes of 653 Patients over 18 Years
Zenon Pogorelić1,2, Ivan Lovrinčević1, Jakov Todorić1
1Department of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia.
Insights
Monocryl Plus sutures significantly reduced surgical site infections (SSIs) and hospital stays in pediatric urological reconstructive surgery compared to Monocryl. Benefits were most pronounced in hypospadias repair, indicating suture choice impacts outcomes.
Area of Science:
- Pediatric Urology
- Surgical Site Infection (SSI) Prevention
- Biomaterials in Surgery
Background:
- Surgical site infections (SSIs) are a significant complication in pediatric urological reconstructive surgery.
- Antibacterial-coated sutures, such as Monocryl Plus, offer potential for SSI reduction, but pediatric data is limited.
- This study compares Monocryl Plus versus standard Monocryl sutures in pediatric urological procedures.
Purpose of the Study:
- To evaluate the efficacy of Monocryl Plus antibacterial-coated sutures in reducing SSIs in pediatric urological reconstructive surgery.
- To compare secondary outcomes including overall complications, reoperations, readmissions, and length of hospital stay between suture types.
Main Methods:
- Retrospective review of 653 pediatric patients undergoing reconstructive surgery for hydronephrosis, vesicoureteral reflux (VUR), or hypospadias (2008-2025).
- Patients were grouped by suture type: Monocryl® vs. Monocryl Plus®.
- Primary endpoint: SSI within 30 days. Secondary endpoints: complications, reoperations, readmissions, hospital stay.
Main Results:
- Monocryl Plus demonstrated a significantly lower SSI rate (3.8% vs. 6.9%, p=0.04) and shorter median hospital stay (5 vs. 6 days, p=0.02).
- While trends favored Monocryl Plus for overall complications, reoperations, and readmissions, these did not reach statistical significance.
- Hypospadias repair subgroup showed significant reductions in SSI (p=0.04) and fistula rates (p=0.03) with Monocryl Plus. Multivariate analysis confirmed Monocryl Plus independently associated with lower SSI odds (OR 0.55) and reduced prolonged hospitalization (OR 0.59).
Conclusions:
- Monocryl Plus sutures are associated with significantly fewer SSIs and shorter hospital stays in pediatric urological reconstructive surgery compared to Monocryl.
- The benefits of Monocryl Plus appear most pronounced in hypospadias repair, suggesting a potential role in optimizing outcomes for specific pediatric urological procedures.
- Further prospective studies may elucidate the full impact of antibacterial sutures on complication profiles in this patient population.
Background:
Surgical site infection (SSI) remains a major concern in pediatric urological reconstructive surgery. Antibacterial-coated absorbable sutures like Monocryl Plus® have been introduced to reduce SSI, but evidence in pediatric populations is limited. This study aimed to compare outcomes between Monocryl® and Monocryl Plus® sutures in common pediatric urological procedures.
Methods:
A retrospective review was conducted of all children who underwent reconstructive urological surgery for hydronephrosis, vesicoureteral reflux (VUR), or hypospadias at the University Hospital of Split between January 2008 and December 2025. A total of 653 patients were included: 149 with hydronephrosis, 187 with VUR, and 317 with hypospadias. Patients were grouped based on suture type (Monocryl® vs. Monocryl Plus®). The primary outcome was SSI within 30 days after surgery; secondary outcomes included overall complications, reoperations, readmissions, and length of hospital stay.
Results:
SSI occurred less frequently with Monocryl Plus than with Monocryl (3.8% vs. 6.9%, p = 0.04). The median length of stay was shorter in the Monocryl Plus group (5 days, IQR 4-7) compared to Monocryl (6 days, IQR 5-8; p = 0.02). Overall complication rates were 6.1% vs. 10.0% (p = 0.07), early complications 4.6% vs. 8.0% (p = 0.06), and late complications 2.3% vs. 4.2% (p = 0.18), favouring Monocryl Plus but without statistical significance. Reoperation was required in 1.8% vs. 3.4% (p = 0.19), and readmission in 2.6% vs. 5.0% (p = 0.12). Subgroup analysis showed minimal differences in hydronephrosis (all p > 0.6), modest reductions in VUR (SSI 8.1% vs. 4.4%, p = 0.21), and significant differences in hypospadias (SSI 7.8% vs. 4.2%, p = 0.04; fistula 12.2% vs. 6.5%, p = 0.03). Multivariate regression confirmed Monocryl Plus as independently associated with lower odds of SSI (OR 0.55, 95% CI 0.30-0.98, p = 0.04) and prolonged hospitalization >7 days (OR 0.59, 95% CI 0.38-0.91, p = 0.02).
Conclusions:
In pediatric urological reconstructive surgery, Monocryl Plus sutures were associated with significantly fewer SSIs and shorter hospital stays compared to traditional Monocryl. Although the overall complication, reoperation, and readmission rates showed nonsignificant trends favouring Monocryl Plus, the most notable benefits appeared in hypospadias repair, suggesting that suture choice might influence outcomes in this subgroup.
