Which suture material is most likely to provoke tissue reaction?

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

Answer: (A)

Biocompatibility and tissue reactivity are driven by how the material interacts with the body's inflammatory system. Natural gut sutures come from animal tissue and contain collagen, which the body sees as more foreign. Even after chromium salt treatment to slow absorption, they tend to provoke a stronger inflammatory response as they degrade, producing foreign-protein fragments that recruit inflammatory cells. That sharper, early reaction makes chromic gut more likely to cause tissue reaction than the synthetic options.

Nylon and Prolene are inert, nonabsorbable synthetics, so they generally generate minimal inflammatory response. Vicryl is a synthetic absorbable material (polyglactin) and, while it does induce some reaction during degradation, its overall tissue response is typically less than that of gut sutures.

So chromic gut stands out as the material most likely to provoke tissue reaction among these choices.