Penile Zipper Injury

Abstract

Objective: To report 2 cases with pediatric penile trauma due to penile zipper injury. Clinical Presentation and Intervention: Two boys presented to the emergency service because of penile zipper injury. The zipper was cut away and removed from the foreskin by cutting the median bar of the sliding piece of the zipper and the zipper teeth with a bone cutter. After opening the zipper teeth, the zipper fell apart, which allowed its removal from their foreskin. There was minimal trauma to the foreskin and the boys were sent home on the same day. Conclusion: Penile entrapment in a zipper is a presentation that may be seen in any emergency department. The 2 boys were treated successfully by cutting the median bar of the sliding piece of the zipper.

Ultrasound‐guided dorsal penile nerve block performed in a case of zipper entrapment injury

“…The most common penile emergencies in adults include phimosis, paraphimosis, and priapism. Zipper entrapment is a less frequent presentation; however, it carries the potential for significant morbidity and should therefore be managed with equal importance . Patient embarrassment can result in delayed presentation, thereby increasing the risk for tissue necrosis and ischemia .…”

“…Zipper entrapment is a less frequent presentation; however, it carries the potential for significant morbidity and should therefore be managed with equal importance. 3 Patient embarrassment can result in delayed presentation, thereby increasing the risk for tissue necrosis and ischemia. 4 Given the sensitivity of the skin surrounding the genital region, zipper entrapment injuries are extremely painful, and the pain is often exacerbated with any movement or palpation.…”

A new nonsurgical technique for managing zipper injuries

“…Other methods involve using pliers for lateral compression of the zipper fastener connector [7] and bone cutters to cut the median bar of the zipper connector and teeth [3], and necessitate equipment not readily found on the ward. Another novel nonsurgical technique involves the insertion of a small screwdriver head between the outer and the inner faceplates of the zip connector.…”

“…The teeth interact with the connector's superior and inferior surface. Management techniques described include the use of mineral oil, cutting of the median bar of the zipper connector [3] and circumcision. We would like to introduce a new, simple and fast procedure that could be performed by junior nonexpert staff to avoid delays of treatment and to reduce hospital resources.…”

Foreskin trapped by zipper: a case report

“…Mishra described a technique for releasing the foreskin of the zipper using ordinary wire cutter [2]. Others authors perform traction of the zipper [3]. It is usually ineffective the application of oil to sliding the zipper [4].…”