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HWN Suggests

Penile Injuries

One of the more difficult aspects of management of these injuries is reassurance and anxiolysis to the patient and perhaps their partner or parent in the case of a child with a zipper injury. There is often a morbid curiosity on the part of members of the treatment team including other physicians and nurses. For the sake of maintaining a calm patient who trusts in you as you approach the penis with a tool that looks like and may have come from the hospital mechanical maintenance room, try to avoid spectacle and treat the patient with dignity and respect and perhaps a bit of a benzodiazepine. This will make them feel more comfortable and make your job easier.

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  Trick of Trade: Removal of Entrapped Metal Zipper

The zipper should be separated from the pants as much as possible to minimize painful stretching or pulling of the penile skin. Apply lidocaine gel on the area of entrapment for 2-3 minutes. Identify the exposed teeth closest to slider and cut off the zipper at that level (blue dots) while avoiding penile skin. Gently advance the zipper body forward, pulling either the tab or the body itself, to disengage it from the teeth. You may need to add more lidocaine gel or other lubrication to facilitate this sliding motion. The remaining parts of the zipper can easily be disengaged from the skin

 Unlocking Common ED Procedures: Penile Zipper Injuries and Entrapment

In regard to penile zipper entrapment, two main types of injury have been identified. These include penile tissue getting caught in the sliding mechanism itself as well as penile tissue getting caught between the zipper teeth. It is important to identify the exact mechanism as they have different approaches to liberating the patient from the entrapment. If the mechanism is not easily identifiable, better exposure should be obtained. In this case, it would mean cutting the clothing off around the zipper, leaving only the zipper and immediately surrounding fabric still attached to the patient. This will allow for different lines of sight to better identify the type and extent of injury.

Articles of Interest

Management of zipper entrapment injuries

The technique for managing zipper injuries depends upon the site of entrapment within the zipper (zipper teeth alone or zipper with fastener).

Penile ring entrapment – A true urologic emergency: Grading, approach, and management

PRE is a rare, true urologic emergency that can lead to penile amputation. Management should be urgent and directed toward removing the ring while protecting underlying tissue. Treatment is based on the severity of the presentation and the tools at the physician's disposa

Penile Zipper and Ring Injuries

While generally rare, injuries to the penis from zipper entrapment are actually the most common cause of penile trauma in adults, with roughly 2,000 reported cases yearly. When they occur, the individual often presents to the emergency department with the prepuce caught in the zipper after having unsuccessfully tried home management.

Penile zipper injury

There are two patterns of entrapment seen...

The Zipperator! A Novel Model to Simulate Penile Zipper Entrapment

Through the use of a well-known household board game and supplies commonly found in the emergency department, we created a simulated model that could be easily replicated. This simple model provided practice of the hand motions necessary for zipper entrapment release, as well as familiarity with the mental and physical approaches to dislodging the entrapment.

Zany Zipper

The method of removal depends on where the genital skin is entrapped. The skin of the foreskin or scrotum may become stuck in two main sites: Between the teeth of the zipper, Within the sliding part of the zipper.

Zipper-Related Penis Injuries: A Medical Concern of Modern-Day Men

Although the separable fastener, marketed as the zipper, has become a necessary component of modern life, its convenience comes at a price: its attack upon the penis.