Which of the following suture types has the highest likelihood of tissue reaction?

• A. Nylon
• B. Vicryl
• C. Prolene
• D. Chromic gut

Answer: (C)

The amount of tissue reaction to a suture largely depends on what the suture is made of and whether it’s absorbed. Natural, absorbable materials tend to provoke more inflammation as they are broken down.

Chromic gut is collagen from animal tissue that’s treated to slow absorption. Because it’s natural and absorbable, it triggers a more robust inflammatory response during healing, leading to the highest tissue reaction among these options.

In contrast, Vicryl is a braided synthetic absorbable suture, which can cause some reaction due to its braided surface and absorption, but it’s generally less reactive than natural gut. Nylon and Prolene are inert, non-absorbable synthetics; they provoke the least inflammation and are favored when minimal tissue reaction is desired.

So the suture with the greatest likelihood of tissue reaction is chromic gut.