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This is a PatientPlus article. PatientPlus articles are written for doctors and so the language can be technical. However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.

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 commonest 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 4068 new patient attendances.2

Management

Various options can be tried, some more invasive than others:

  • 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.
    ZIPPED PENIS (OM1937a.jpg)
  • 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 twisting movement is 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.

Document references
  1. Yip A, Ng SK, Wong WC, et al; Injury to the prepuce. Br J Urol. 1989 May;63(5):535-8. [abstract]
  2. Wyatt JP, Scobie WG; The management of penile zip entrapment in children. Injury. 1994 Jan;25(1):59-60. [abstract]
  3. Mishra SC; Safe and painless manipulation of penile zipper entrapment. Indian Pediatr. 2006 Mar;43(3):252-4. [abstract]
  4. Inoue N, Crook SC, Yamamoto LG; Comparing 2 methods of emergent zipper release. Am J Emerg Med. 2005 Jul;23(4):480-2. [abstract]
  5. Raveenthiran V; Releasing of zipper-entrapped foreskin: a novel nonsurgical technique. Pediatr Emerg Care. 2007 Jul;23(7):463-4. [abstract]
  6. Mydlo JH; Treatment of a delayed zipper injury. Urol Int. 2000;64(1):45-6. [abstract]
Acknowledgements EMIS is grateful to Dr Laurence Knott for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2008.
DocID: 1731
Document Version: 21
DocRef: bgp1937
Last Updated: 26 Oct 2008
Review Date: 26 Oct 2010

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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