Zipper injury to penis

Background

Penis anatomy

The human male urethra laid open on its anterior (upper) surface.

Transverse section of the penis.

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

Clinical Features

Foreskin trapped by his zipper.

• Penile or scrotal tissue caught in zipper

Differential Diagnosis

Penile trauma types

• Penile amputation
• Penile contusion
• Penile fracture
• Traumatic epididymitis
• Zipper injury to penis

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
• Avulsed penile skin should not be reapplied (invariably becomes necrotic and infected)

Disposition

• Discharge

See Also

• Penile trauma