Zipped Penis

Description

An area of skin, often of the penis or neck, becomes painfully trapped in a zipper mechanism. Unzipping the zipper will lacerate the skin and cause further damage.

Epidemiology

This condition is relatively rarely seen, but is the most common cause of prepuce injuries in children. In one study, only 6 boys were seen over a period of 3 years.^[1]In another, there was only one case of zip entrapment in 4,068 new patient attendances.^[2]

Management

Various options can be tried, some more invasive than others. It is usually necessary to dismantle the zip. If the skin trapped is minor and recent, dismantling the zip from below will sometimes work. If this is not successful then a technique to release the pressure between the zip plates will free the trapped skin. The options include the following:

• It may be possible to dismantle the zip. If the median bar at the front of the moveable zip head is cut in half, the zipper falls apart freeing the skin relatively painlessly. Use bone cutter or wire clippers for this. Considerable force may be needed.
   
• Lateral compression of the zip, using pliers, sometimes frees the prepuce.^[3]
• Cutting the teeth of the closed zipper is sometimes effective.^[4]
• The thin blade of a small screwdriver can be inserted between the outer and inner faceplates of the zip fastener and a twisting movement made toward the median bar. This will widen the gap between faceplates and may help to disengage the prepuce.^[5]
• If all else fails, the skin should be anaesthetised and the area of zipper and entrapped tissue should be excised. Mineral oil is sometimes used in these circumstances to lubricate the area and minimise trauma.^[6]
• Consider plastic surgical follow-up if the skin damage is significant.