Entrapment of penile skin within a zipper, either within the sliding mechanism or between the zipper teeth, or both, is relieved by cutting the sliding mechanism in half using a wire cutter or bone cutter, or by isolating and gently separating the involved zipper segment. Attempts to unzip the zipper may damage the entrapped skin. Sometimes surgery to excise the involved skin may be needed.
(See also Genital Trauma.)
Indications for Removing a Zipper From a Penis
Entrapment of foreskin, penile skin, or scrotal skin within a zipper
Contraindications to Removing a Zipper From a Penis
Absolute contraindications
None
Relative contraindications
None
Complications of Removing a Zipper From a Penis
Complications may include
Damage to skin
Penile laceration
Edema, due to delay of treatment, may make the procedure more difficult and increase risk of tissue damage and necrosis.
Damage to the penis should be evaluated by a urologist, especially if clinical findings suggest urethral injury.
Equipment for Removing a Zipper From a Penis
Antiseptic cleanser (eg, povidone iodine)
Mineral oil
Heavy-duty wire cutter or bone cutter
Sturdy shears, to cut through trouser material and across the zipper
Small (eg, Iris) scissors, to cut the zipper cloth between specific zipper teeth, if necessary, to remove them individually
Topical anesthetic cream or local anesthetic without epinephrine (eg, 1 or 2% lidocaine and a 25- or 27-gauge needle and about a 3-mL syringe)
Additional Considerations for Removing a Zipper From a Penis
This condition is painful, and patients also may be frightened and embarrassed. Calm reassurance is usually adequate to allow the procedure to be done. Occasionally mild sedation may be helpful.
Positioning for Removing a Zipper From a Penis
Position the patient supine. To facilitate positioning, first use a bandage scissors, if necessary, to cut through the trousers peripherally around the zipper, which will relieve painful traction forces on the site and permit trouser removal.
Step-by-Step Description for Removing a Zipper From a Penis
Inject local anesthetic into the area using a 25- or 27-gauge needle, or apply anesthetic cream.
Cut the median bar at the wide end of the zipper slider, which connects its front and back plates, using a sturdy wire cutter (diagonal cutter), or bone cutter. (See figure Zipper removal from penile skin.) The slider will fall off in 2 pieces, allowing the zipper to be removed.
Alternatively, if no cutters are available, lubricate the zipper and tissue at the affected area, using mineral oil liberally.
Wait 10 minutes to allow the mineral oil to spread over the surfaces of the sliding mechanism, zipper teeth, and skin.
Make one gentle attempt to unzip the zipper. If this strategy either is deemed not likely to be successful or is unsuccessful, proceed to the next step. Do not damage the entrapped tissue by trying repeatedly to unzip the zipper.
As another alternative, if no cutters are available, try to separate the zipper teeth by cutting the cloth between them using a small (eg, Iris) scissors.
Звільнення шкіри статевого члена із застібки-блискавки
If these measures fail or are not feasible:
Obtain urologic consultation for possible elliptical skin excision or emergency circumcision.
Aftercare for Removing a Zipper From a Penis
Control bleeding with gentle local pressure.
Clean the site with warm water and soap.
Apply antibiotic ointment (eg, bacitracin) and wrap loosely in sterile gauze.
Warnings and Common Errors for Removing a Zipper From a Penis
Stop trying to unzip the zipper if one attempt is unsuccessful.
Tips and Tricks for Removing a Zipper From a Penis
Obtain and store appropriate sturdy cutters in a convenient location in advance as they may not be readily available otherwise.
