ABSTRACT
The effectiveness of silicone cuffing in peripheral nerve repairs was assessed in
a comparative study in rats. The femoral nerve was dissected out and severed bilaterally.
The nerve ends were brought together with four epineural sutures on one side, while
only one epineural suture was used on the other side, placing a silicone cuff around
the junction site. Initially, nerve regeneration appeared to be improved by the cuff,
with electrophysiologic parameters and histologic studies 6 weeks after the procedure
yielding better results for the tubulated nerves. Subsequently, however, conductivity
was less in the tubulated nerves, and results were clearly inferior to sutured nerves
at 4 months after the operation. The deterioration was due to nerve compression caused
by the cuff, which prevented axons from penetrating into the distal nerve stump, and
resulted in axon fragmentation in the compressed nerve segment. The risk of nerve
compression makes the use of silicone cuffs of doubtful value.
