Zipper injury to penis

Background
  • Most common in young children and adolescents
  • Rapid extrication is recommended to avoid worsening edema and further tissue damage

Clinical Features
  • Penile or scrotal tissue caught in zipper

Differential Diagnosis

Penile trauma

Evaluation
  • Clinical diagnosis

Management
  • Expose the area by cutting clothing around zipper.
  • Give pain control (e.g. IN Fentanyl) for extrication
    • May require conscious sedation.
  • Mineral oil (applied topically for 10-15 minutes) and lidocaine infiltration can be used to free the penile skin.
  • Wire-cutting or bone-cutting pliers can be used to cut the median bar of the zipper[1]
  • Avulsed penile skin should not be reapplied (invariably becomes necrotic and infected)

Disposition
  • Discharge

See Also

References
  1. Nakagawa, T. and Toguri, A. G. (2006) ‘Penile Zipper Injury’, Medical Principles and Practice, 15(4), pp. 303–304.
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