Which suture can safely be used in the presence of infection?

Polypropylene is the correct choice when considering sutures that can safely be used in the presence of infection. This material is a synthetic, non-absorbable monofilament suture that exhibits exceptional resistance to infection because it does not promote bacterial colonization. Furthermore, its non-reactive nature means that it is less likely to provoke an inflammatory response in infected tissues.

In contrast, other sutures, such as chromic gut and catgut, which are derived from animal sources, can be absorbed by the body and have a higher tendency to elicit a tissue inflammatory response. Silk, while having excellent tensile strength, is known to be more reactive than polypropylene and can also harbor bacteria due to its braided structure, increasing the risk of infection in contaminated sites. Therefore, polypropylene stands out as the most suitable option for use in infected environments, making it a preferred choice in surgical settings where infection is a concern.