Silicone cuffs for peripheral nerve repair: experimental findings

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.