Surgical site infections (SSI) are amongst the most common medical infections, occurring in 2 to 4% of patients undergoing a surgical procedure. Smart surgical sutures can play an important role in preventing infection. For example, antimicrobial sutures detectable via clinical imaging modalities can support monitoring wounds post-surgery and enhance patient recovery. However, no commercial suture products possess these properties. Herein, contrasting iodine carbon nanoparticles (ICPs) are synthesized using a solvothermal approach. These ICPs were incorporated into polycaprolactone (PCL) via a coaxial extrusion technique inspired by the "core-shell" multilayered suture structure, which integrates multiple clinically favourable functions into one suture device. This system exhibits high imaging contrast capabilities for real-time imaging even after 22 days in-vitro, with strong antimicrobial properties and a reduction in biofilm formation. The multifunctional and biocompatible suture composite developed in this study shows strong antimicrobial properties and can act as an immobilized marker to monitor the surgical site during and after surgical procedures. Identifying suture integrity and location within the body through minimally invasive methods can alleviate patient discomfort and minimize the risk of infection.