Which suture type creates the greatest tissue reaction?

The choice of absorbable sutures is associated with a lower tissue reactivity compared to certain other materials. However, when focusing on which suture type typically generates the most significant tissue reaction, silk would be more appropriate as a reference point. Silk is a natural fiber that is known to elicit a stronger inflammatory response due to its fibrous structure and the body's recognition of it as a foreign material. This natural material can cause more pronounced tissue reactivity compared to synthetic absorbable sutures, which tend to be designed for minimal tissue irritation during the healing process.

In contrast, non-absorbable sutures, such as polyester, also tend to elicit a heightened reaction but are often tolerated due to their stability and longevity. So while absorbable sutures are indeed effective for many applications, the tissue response can vary significantly based on the specific material used, with silk being particularly reactive. Thus, silk represents a suture type known for creating a significant tissue reaction as compared to the absorbable options.