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 dissect ed out and severed bilaterally. The nerve ends were brought together w ith four epineural sutures on one side, while only one epineural sutur e was used on the other side, placing a silicone cuff around the junct ion site. Initially, nerve regeneration appeared to be improved by the cuff, with electrophysiologic parameters and histologic studies 6 wee ks after the procedure yielding better results for the tubulated nerve s. Subsequently, however, conductivity was less in the tubulated nerve s, and results were clearly inferior to sutured nerves at 4 months aft er the operation. The deterioration was due to nerve compression cause d by the cuff, which prevented axons from penetrating into the distal nerve stump, and resulted in axon fragmentation in the compressed nerv e segment. The risk of nerve compression makes the use of silicone cuf fs of doubtful value.